Bowel function, sexual function, and symptoms of pelvic organ prolapse in women with and without urinary incontinence

Anne P. Cameron; Abigail R. Smith; H. Henry Lai; Catherine S. Bradley; Alice B. Liu; Robert M. Merion; Brenda W. Gillespie; Cindy L. Amundsen; David Cella; James W. Griffith; Jonathan B. Wiseman; Karl J. Kreder; Kimberly S. Kenton; Margaret E. Helmuth; Matthew O. Fraser; J. Quentin Clemens; Ziya Kirkali; John W. Kusek; Nazema Y. Siddiqui

doi:10.1002/nau.23587

Bowel function, sexual function, and symptoms of pelvic organ prolapse in women with and without urinary incontinence

Anne P. Cameron^*, Abigail R. Smith, H. Henry Lai, Catherine S. Bradley, Alice B. Liu, Robert M. Merion, Brenda W. Gillespie, Cindy L. Amundsen, David Cella, James W. Griffith, Jonathan B. Wiseman, Karl J. Kreder, Kimberly S. Kenton, Margaret E. Helmuth, Matthew O. Fraser, J. Quentin Clemens, Ziya Kirkali, John W. Kusek, Nazema Y. Siddiqui

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

16 Scopus citations

Abstract

Aims: Bowel symptoms, pelvic organ prolapse, and sexual dysfunction are common, but their frequency among women with lower urinary tract symptoms (LUTS) has not been well described. Our aims were to describe pelvic floor symptoms among women with and without urinary incontinence (UI) and among subtypes of UI. Methods: Women with LUTS seeking care at six U.S. tertiary care centers enrolled in prospective cohort study were studied. At baseline, participants completed the Pelvic Floor Distress Inventory (PFDI-20), Pelvic Organ Prolapse/Incontinence Sexual Questionnaire (PISQ-IR), and PROMIS GI Diarrhea, Constipation, and Fecal Incontinence Scales. Results: Mean age among the 510 women was 56.4 ± 14.4 years. Women who reported UI (n = 420) had more diarrhea and constipation symptoms (mean scores 49.5 vs 46.2 [P = 0.01] and 51.9 vs 48.4 [P < 0.01], respectively) at baseline. Among sexually active women, mean PISQ-IR subscale scores were lower among those with UI (condition specific: 89.8 vs 96.7, P < 0.01; condition impact: 79.8 vs 92.5, P < 0.01). Women with mixed urinary incontinence (MUI) (n = 240) reported more prolapse symptoms, fecal incontinence, and worse sexual function compared to those with stress urinary incontinence (SUI) and urgency urinary incontinence (UUI). Conclusions: Women presenting with LUTS with UI reported significantly worse constipation, diarrhea, fecal incontinence, and sexual function compared to women without UI. In women with UI, sexual function and pelvic organ prolapse (POP) symptoms were worse in those with MUI compared to SUI and UUI.

Original language	English (US)
Pages (from-to)	2586-2596
Number of pages	11
Journal	Neurourology and Urodynamics
Volume	37
Issue number	8
DOIs	https://doi.org/10.1002/nau.23587
State	Published - Nov 2018

Keywords

constipation
fecal incontinence
pelvic organ prolapse
urinary incontinence

ASJC Scopus subject areas

Clinical Neurology
Urology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1002/nau.23587

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Cameron, A. P., Smith, A. R., Lai, H. H., Bradley, C. S., Liu, A. B., Merion, R. M., Gillespie, B. W., Amundsen, C. L., Cella, D., Griffith, J. W., Wiseman, J. B., Kreder, K. J., Kenton, K. S., Helmuth, M. E., Fraser, M. O., Clemens, J. Q., Kirkali, Z., Kusek, J. W., & Siddiqui, N. Y. (2018). Bowel function, sexual function, and symptoms of pelvic organ prolapse in women with and without urinary incontinence. Neurourology and Urodynamics, 37(8), 2586-2596. https://doi.org/10.1002/nau.23587

@article{3d464fcded3c45269b0371505207e495,

title = "Bowel function, sexual function, and symptoms of pelvic organ prolapse in women with and without urinary incontinence",

abstract = "Aims: Bowel symptoms, pelvic organ prolapse, and sexual dysfunction are common, but their frequency among women with lower urinary tract symptoms (LUTS) has not been well described. Our aims were to describe pelvic floor symptoms among women with and without urinary incontinence (UI) and among subtypes of UI. Methods: Women with LUTS seeking care at six U.S. tertiary care centers enrolled in prospective cohort study were studied. At baseline, participants completed the Pelvic Floor Distress Inventory (PFDI-20), Pelvic Organ Prolapse/Incontinence Sexual Questionnaire (PISQ-IR), and PROMIS GI Diarrhea, Constipation, and Fecal Incontinence Scales. Results: Mean age among the 510 women was 56.4 ± 14.4 years. Women who reported UI (n = 420) had more diarrhea and constipation symptoms (mean scores 49.5 vs 46.2 [P = 0.01] and 51.9 vs 48.4 [P < 0.01], respectively) at baseline. Among sexually active women, mean PISQ-IR subscale scores were lower among those with UI (condition specific: 89.8 vs 96.7, P < 0.01; condition impact: 79.8 vs 92.5, P < 0.01). Women with mixed urinary incontinence (MUI) (n = 240) reported more prolapse symptoms, fecal incontinence, and worse sexual function compared to those with stress urinary incontinence (SUI) and urgency urinary incontinence (UUI). Conclusions: Women presenting with LUTS with UI reported significantly worse constipation, diarrhea, fecal incontinence, and sexual function compared to women without UI. In women with UI, sexual function and pelvic organ prolapse (POP) symptoms were worse in those with MUI compared to SUI and UUI.",

keywords = "constipation, fecal incontinence, pelvic organ prolapse, urinary incontinence",

author = "Cameron, {Anne P.} and Smith, {Abigail R.} and Lai, {H. Henry} and Bradley, {Catherine S.} and Liu, {Alice B.} and Merion, {Robert M.} and Gillespie, {Brenda W.} and Amundsen, {Cindy L.} and David Cella and Griffith, {James W.} and Wiseman, {Jonathan B.} and Kreder, {Karl J.} and Kenton, {Kimberly S.} and Helmuth, {Margaret E.} and Fraser, {Matthew O.} and Clemens, {J. Quentin} and Ziya Kirkali and Kusek, {John W.} and Siddiqui, {Nazema Y.}",

note = "Funding Information: Yes, Catherine S. Bradley reports grants from NIH/NIDDK, during the conduct of the study. Anne P. Cameron reports non-financial support from Medtronic, personal fees from Allergan, personal fees from Wellspect, outside the submitted work. David Cella reports grants from NIDDK, during the conduct of the study. J. Quentin Clemens reports grants from NIDDK, from null, during the conduct of the study. Margaret E. Helmuth reports grants from National Institute of Diabetes and Digestive and Kidney Diseases, during the conduct of the study. Kimberly S. Kenton reports grants from NIH-NIDDK, grants from Boston Scientific, from null, outside the submitted work. Dr. Kreder reports grants from NIDDK, during the conduct of the study. H. Henry Lai reports grants from National Institutes of Health, during the conduct of the study; other from Allergan, other from Medtronic, other from Aquinox, outside the submitted work. Nazema Y. Siddiqui reports grants from NIH/ NIDDK, during the conduct of the study; grants from Medtronic Inc, outside the submitted work. The other coauthors have nothing to declare. Funding Information: This study is supported by the National Institute of Diabetes and Digestive and Kidney Diseases through cooperative agreements (grants DK097780, DK097772, DK097779, DK099932, DK100011, DK100017, DK097776, DK099879). Research reported in this publication was supported at Northwestern University, in part, by the National Institutes of Health's National Center for Advancing Translational Sciences, Grant Number UL1TR001422. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The following individuals were instrumental in the planning and conduct of this study at each of the participating institutions: 1) Duke University, Durham, North Carolina (DK097780): PI: Cindy Amundsen, MD, Kevin Weinfurt, PhD; Co-Is: Kathryn Flynn, PhD, Matthew O. Fraser, PhD, Todd Harshbarger, PhD, Eric Jelovsek, MD, Aaron Lentz, MD, Drew Peterson, MD, Nazema Siddiqui, MD, Alison Weidner, MD; Study Coordinators: Carrie Dombeck, MA, Robin Gilliam, MSW, Akira Hayes, Shantae McLean, MPH; 2) University of Iowa, Iowa City, IA (DK097772): PI: Karl Kreder, MD, MBA, Catherine S Bradley, MD, MSCE, Co-Is: Bradley A. Erickson, MD, MS, Susan K. Lutgendorf, PhD, Vince Magnotta, PhD, Michael A. O{\textquoteright}Donnell, MD, Vivian Sung, MD; Study Coordinator: Ahmad Alzubaidi; 3) Northwestern University, Chicago, IL (DK097779): PIs: David Cella, Brian Helfand, MD, PhD; Co-Is: James W Griffith, PhD, Kimberly Kenton, MD, MS, Christina Lewicky-Gaupp, MD, Todd Parrish, PhD, Jennie Yufen Chen, PhD, Margaret Mueller, MD; Study Coordinators: Sarah Buono, Maria Corona, Beatriz Menendez, Alexis Siurek, Meera Tavathia, Veronica Venezuela, Azra Muftic, Pooja Talaty, Jasmine Nero. Dr. Helfand, Ms. Talaty, and Ms. Nero are at NorthShore University HealthSystem; 4) University of Michigan Health System, Ann Arbor, MI (DK099932): PI: J Quentin Clemens, MD, FACS, MSCI; Co-Is: Mitch Berger, MD, PhD, John DeLancey, MD, Dee Fenner, MD, Rick Harris, MD, Steve Harte, PhD, Anne P. Cameron, MD, John Wei, MD; Study Coordinators: Morgen Barroso, Linda Drnek, Greg Mowatt, Julie Tumbarello; 5) University of Washington, Seattle Washington (DK100011): PI: Claire Yang, MD; Co-I: John L. Gore, MD, MS; Study Coordinators: Alice Liu, MPH, Brenda Vicars, RN; 6) Washington University in St. Louis, St. Louis Missouri (DK100017): PI: Gerald L. Andriole, MD, H. Henry Lai; Co-I: Joshua Shimony, MD, PhD; Study Coordinators: Susan Mueller, RN, BSN, Heather Wilson, LPN, Deborah Ksiazek, BS, Aleksandra Klim, RN, MHS, CCRC; 7) National Institute of Diabetes and Digestive and Kidney Diseases, Division of Kidney, Urology, and Hematology, Bethesda, MD: Project Scientist: Ziya Kirkali MD; Project Officer: John Kusek, PhD; NIH Personnel: Tamara Bavendam, MD, Robert Star, MD, Jenna Norton; and 8) Arbor Research Collaborative for Health, Data Coordinating Center (DK097776 and DK099879): PI: Robert Merion, MD, FACS; Co-Is: Victor Andreev, PhD, DSc, Brenda Gillespie, PhD, Gang Liu, PhD, Abigail Smith, PhD; Project Manager: Melissa Fava, MPA, PMP; Clinical Study Process Manager: Peg Hill-Callahan, BS, LSW; Clinical Monitor: Timothy Buck, BS, CCRP; Research Analysts: Margaret Helmuth, MA, Jon Wiseman, MS; Project Associate: Julieanne Lock, MLitt. Publisher Copyright: {\textcopyright} 2018 Wiley Periodicals, Inc.",

year = "2018",

month = nov,

doi = "10.1002/nau.23587",

language = "English (US)",

volume = "37",

pages = "2586--2596",

journal = "Neurourology and Urodynamics",

issn = "0733-2467",

publisher = "Wiley-Liss Inc.",

number = "8",

}

Cameron, AP, Smith, AR, Lai, HH, Bradley, CS, Liu, AB, Merion, RM, Gillespie, BW, Amundsen, CL, Cella, D , Griffith, JW, Wiseman, JB, Kreder, KJ, Kenton, KS, Helmuth, ME, Fraser, MO, Clemens, JQ, Kirkali, Z, Kusek, JW & Siddiqui, NY 2018, 'Bowel function, sexual function, and symptoms of pelvic organ prolapse in women with and without urinary incontinence', Neurourology and Urodynamics, vol. 37, no. 8, pp. 2586-2596. https://doi.org/10.1002/nau.23587

TY - JOUR

T1 - Bowel function, sexual function, and symptoms of pelvic organ prolapse in women with and without urinary incontinence

AU - Cameron, Anne P.

AU - Smith, Abigail R.

AU - Lai, H. Henry

AU - Bradley, Catherine S.

AU - Liu, Alice B.

AU - Merion, Robert M.

AU - Gillespie, Brenda W.

AU - Amundsen, Cindy L.

AU - Cella, David

AU - Griffith, James W.

AU - Wiseman, Jonathan B.

AU - Kreder, Karl J.

AU - Kenton, Kimberly S.

AU - Helmuth, Margaret E.

AU - Fraser, Matthew O.

AU - Clemens, J. Quentin

AU - Kirkali, Ziya

AU - Kusek, John W.

AU - Siddiqui, Nazema Y.

N1 - Funding Information: Yes, Catherine S. Bradley reports grants from NIH/NIDDK, during the conduct of the study. Anne P. Cameron reports non-financial support from Medtronic, personal fees from Allergan, personal fees from Wellspect, outside the submitted work. David Cella reports grants from NIDDK, during the conduct of the study. J. Quentin Clemens reports grants from NIDDK, from null, during the conduct of the study. Margaret E. Helmuth reports grants from National Institute of Diabetes and Digestive and Kidney Diseases, during the conduct of the study. Kimberly S. Kenton reports grants from NIH-NIDDK, grants from Boston Scientific, from null, outside the submitted work. Dr. Kreder reports grants from NIDDK, during the conduct of the study. H. Henry Lai reports grants from National Institutes of Health, during the conduct of the study; other from Allergan, other from Medtronic, other from Aquinox, outside the submitted work. Nazema Y. Siddiqui reports grants from NIH/ NIDDK, during the conduct of the study; grants from Medtronic Inc, outside the submitted work. The other coauthors have nothing to declare. Funding Information: This study is supported by the National Institute of Diabetes and Digestive and Kidney Diseases through cooperative agreements (grants DK097780, DK097772, DK097779, DK099932, DK100011, DK100017, DK097776, DK099879). Research reported in this publication was supported at Northwestern University, in part, by the National Institutes of Health's National Center for Advancing Translational Sciences, Grant Number UL1TR001422. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The following individuals were instrumental in the planning and conduct of this study at each of the participating institutions: 1) Duke University, Durham, North Carolina (DK097780): PI: Cindy Amundsen, MD, Kevin Weinfurt, PhD; Co-Is: Kathryn Flynn, PhD, Matthew O. Fraser, PhD, Todd Harshbarger, PhD, Eric Jelovsek, MD, Aaron Lentz, MD, Drew Peterson, MD, Nazema Siddiqui, MD, Alison Weidner, MD; Study Coordinators: Carrie Dombeck, MA, Robin Gilliam, MSW, Akira Hayes, Shantae McLean, MPH; 2) University of Iowa, Iowa City, IA (DK097772): PI: Karl Kreder, MD, MBA, Catherine S Bradley, MD, MSCE, Co-Is: Bradley A. Erickson, MD, MS, Susan K. Lutgendorf, PhD, Vince Magnotta, PhD, Michael A. O’Donnell, MD, Vivian Sung, MD; Study Coordinator: Ahmad Alzubaidi; 3) Northwestern University, Chicago, IL (DK097779): PIs: David Cella, Brian Helfand, MD, PhD; Co-Is: James W Griffith, PhD, Kimberly Kenton, MD, MS, Christina Lewicky-Gaupp, MD, Todd Parrish, PhD, Jennie Yufen Chen, PhD, Margaret Mueller, MD; Study Coordinators: Sarah Buono, Maria Corona, Beatriz Menendez, Alexis Siurek, Meera Tavathia, Veronica Venezuela, Azra Muftic, Pooja Talaty, Jasmine Nero. Dr. Helfand, Ms. Talaty, and Ms. Nero are at NorthShore University HealthSystem; 4) University of Michigan Health System, Ann Arbor, MI (DK099932): PI: J Quentin Clemens, MD, FACS, MSCI; Co-Is: Mitch Berger, MD, PhD, John DeLancey, MD, Dee Fenner, MD, Rick Harris, MD, Steve Harte, PhD, Anne P. Cameron, MD, John Wei, MD; Study Coordinators: Morgen Barroso, Linda Drnek, Greg Mowatt, Julie Tumbarello; 5) University of Washington, Seattle Washington (DK100011): PI: Claire Yang, MD; Co-I: John L. Gore, MD, MS; Study Coordinators: Alice Liu, MPH, Brenda Vicars, RN; 6) Washington University in St. Louis, St. Louis Missouri (DK100017): PI: Gerald L. Andriole, MD, H. Henry Lai; Co-I: Joshua Shimony, MD, PhD; Study Coordinators: Susan Mueller, RN, BSN, Heather Wilson, LPN, Deborah Ksiazek, BS, Aleksandra Klim, RN, MHS, CCRC; 7) National Institute of Diabetes and Digestive and Kidney Diseases, Division of Kidney, Urology, and Hematology, Bethesda, MD: Project Scientist: Ziya Kirkali MD; Project Officer: John Kusek, PhD; NIH Personnel: Tamara Bavendam, MD, Robert Star, MD, Jenna Norton; and 8) Arbor Research Collaborative for Health, Data Coordinating Center (DK097776 and DK099879): PI: Robert Merion, MD, FACS; Co-Is: Victor Andreev, PhD, DSc, Brenda Gillespie, PhD, Gang Liu, PhD, Abigail Smith, PhD; Project Manager: Melissa Fava, MPA, PMP; Clinical Study Process Manager: Peg Hill-Callahan, BS, LSW; Clinical Monitor: Timothy Buck, BS, CCRP; Research Analysts: Margaret Helmuth, MA, Jon Wiseman, MS; Project Associate: Julieanne Lock, MLitt. Publisher Copyright: © 2018 Wiley Periodicals, Inc.

PY - 2018/11

Y1 - 2018/11

N2 - Aims: Bowel symptoms, pelvic organ prolapse, and sexual dysfunction are common, but their frequency among women with lower urinary tract symptoms (LUTS) has not been well described. Our aims were to describe pelvic floor symptoms among women with and without urinary incontinence (UI) and among subtypes of UI. Methods: Women with LUTS seeking care at six U.S. tertiary care centers enrolled in prospective cohort study were studied. At baseline, participants completed the Pelvic Floor Distress Inventory (PFDI-20), Pelvic Organ Prolapse/Incontinence Sexual Questionnaire (PISQ-IR), and PROMIS GI Diarrhea, Constipation, and Fecal Incontinence Scales. Results: Mean age among the 510 women was 56.4 ± 14.4 years. Women who reported UI (n = 420) had more diarrhea and constipation symptoms (mean scores 49.5 vs 46.2 [P = 0.01] and 51.9 vs 48.4 [P < 0.01], respectively) at baseline. Among sexually active women, mean PISQ-IR subscale scores were lower among those with UI (condition specific: 89.8 vs 96.7, P < 0.01; condition impact: 79.8 vs 92.5, P < 0.01). Women with mixed urinary incontinence (MUI) (n = 240) reported more prolapse symptoms, fecal incontinence, and worse sexual function compared to those with stress urinary incontinence (SUI) and urgency urinary incontinence (UUI). Conclusions: Women presenting with LUTS with UI reported significantly worse constipation, diarrhea, fecal incontinence, and sexual function compared to women without UI. In women with UI, sexual function and pelvic organ prolapse (POP) symptoms were worse in those with MUI compared to SUI and UUI.

AB - Aims: Bowel symptoms, pelvic organ prolapse, and sexual dysfunction are common, but their frequency among women with lower urinary tract symptoms (LUTS) has not been well described. Our aims were to describe pelvic floor symptoms among women with and without urinary incontinence (UI) and among subtypes of UI. Methods: Women with LUTS seeking care at six U.S. tertiary care centers enrolled in prospective cohort study were studied. At baseline, participants completed the Pelvic Floor Distress Inventory (PFDI-20), Pelvic Organ Prolapse/Incontinence Sexual Questionnaire (PISQ-IR), and PROMIS GI Diarrhea, Constipation, and Fecal Incontinence Scales. Results: Mean age among the 510 women was 56.4 ± 14.4 years. Women who reported UI (n = 420) had more diarrhea and constipation symptoms (mean scores 49.5 vs 46.2 [P = 0.01] and 51.9 vs 48.4 [P < 0.01], respectively) at baseline. Among sexually active women, mean PISQ-IR subscale scores were lower among those with UI (condition specific: 89.8 vs 96.7, P < 0.01; condition impact: 79.8 vs 92.5, P < 0.01). Women with mixed urinary incontinence (MUI) (n = 240) reported more prolapse symptoms, fecal incontinence, and worse sexual function compared to those with stress urinary incontinence (SUI) and urgency urinary incontinence (UUI). Conclusions: Women presenting with LUTS with UI reported significantly worse constipation, diarrhea, fecal incontinence, and sexual function compared to women without UI. In women with UI, sexual function and pelvic organ prolapse (POP) symptoms were worse in those with MUI compared to SUI and UUI.

KW - constipation

KW - fecal incontinence

KW - pelvic organ prolapse

KW - urinary incontinence

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UR - http://www.scopus.com/inward/citedby.url?scp=85045222525&partnerID=8YFLogxK

U2 - 10.1002/nau.23587

DO - 10.1002/nau.23587

M3 - Article

C2 - 29635702

AN - SCOPUS:85045222525

SN - 0733-2467

VL - 37

SP - 2586

EP - 2596

JO - Neurourology and Urodynamics

JF - Neurourology and Urodynamics

IS - 8

ER -

Bowel function, sexual function, and symptoms of pelvic organ prolapse in women with and without urinary incontinence

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