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Williams Gynecology
| Section 3 Female Pelvic Medicine and Reconstructive Surgery > |
Chapter 25. Anal Incontinence and Functional Anorectal Disorders
Sections: Anal Incontinence, Functional Anorectal Disorders, Rectovaginal Fistula, References.
Topics Discussed: incontinence, anal.
Excerpt:"Anal incontinence (AI) is an involuntary loss of flatus, liquid, or solid stool that causes a social or hygienic problem (Abrams, 2005). This condition may lead to poor self-image and social isolation, thus significantly impairing quality of life (Johanson, 1996; Perry, 2002). Additionally, AI creates a substantial financial burden to patients and the health care system (Whitehead, 2001).Anal incontinence is common and affects all age groups. In contrast to previous beliefs, it affects men and women similarly (Madoff, 2004; Nelson, 2004). In a recent systematic review of the literature, Macmillan and co-workers (2004) reported that the estimated prevalence of AI among community-dwelling adults ranges between 2 and 24 percent if flatal incontinence is included, and between 0.4 and 18 percent if flatal incontinence is not (Macmillan, 2004). Wide variations are attributed to differences in definition, lack of validated tools, and surveyed cohort's age. In a multicenter trial that included seven geographically distinct sites in the United States, Boreham and co-workers (2005) reported the prevalence, risk factors, and impact upon quality of life of AI in women aged 18 to 65 years presenting for benign gynecologic care. The overall prevalence of AI in this cohort was..."
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