You could be reading the full-text of this article now if you...

If you have access to this article through your institution,
you can view this article in

Functional Bowel Disorders and Pelvic Organ Prolapse: A Case-Control Study

Jelovsek, John Eric MD; Walters, Mark D. MD; Paraiso, Marie Fidela R. MD; Barber, Matthew D. MD, MHS

Female Pelvic Medicine & Reconstructive Surgery:
doi: 10.1097/SPV.0b013e3181e4f270
Original Articles
Journal Club
Abstract

Objectives: To compare the relative frequencies of constipation and other functional bowel disorders between patients with and without pelvic organ prolapse (POP).

Methods: This was a case-control study design. Cases were patients with stage 3-4 POP presenting to a urogynecology clinic and controls were patients presenting to a general gynecology or women's health clinic for annual examinations with stage 0-1 vaginal support. Constipation disorders were defined using responses to the Rome II Modular Questionnaire for functional bowel disorders as well as predefined defecatory disorders.

Results: 128 cases and 127 controls were enrolled. After controlling for race, education, and comorbidities, women with POP were more likely to report symptoms consistent with outlet constipation, including straining during a bowel movement (odds ratio [OR] 3.9, confidence interval [CI] 2.1-7.3), feeling of incomplete rectal emptying (OR 4.0, CI 2.1-7.7), a sensation that stool cannot be passed (OR 3.4, CI 1.7-6.7), and splinting (OR 2.7, CI 1.3-5.7). In spite of this, cases were just as likely to meet the criteria for functional constipation or irritable bowel syndrome (IBS) with constipation as controls but more likely to meet the criteria for IBS-any type (OR 3.8, CI 1.6-9.1) as women with POP reported more discomfort or pain in the abdomen (OR 3.4 CI 1.6-7.1) and >3 bowel movements per day (OR 2.9, CI 1.3-6.3).

Conclusions: Patients with POP are more likely to have symptoms of outlet constipation and other functional bowel disorders compared with patients without POP. The Rome II criteria may not be an appropriate classification system for functional bowel disorders in patients with advanced POP.

In Brief

Patients with pelvic organ prolapse are more likely to have symptoms of outlet constipation and other functional bowel disorders than patients without prolapse.

Author Information

From the Obstetrics, Gynecology and Women's Health Institute, Cleveland Clinic, Cleveland, OH.

Reprints: John Eric Jelovsek, MD, Dept. OB/GYN, Cleveland Clinic, Desk A-81, 9500 Euclid Ave, Cleveland, OH 44195. E-mail: jelovsj@ccf.org.

Funding: None.

Copyright © 2010 Wolters Kluwer Health, Inc. All rights reserved.