Clinical impact of bowel symptoms in women with pelvic floor disorders

Introduction and hypothesis The aim of this study was to evaluate the correlations between the POP-Q Bp point and the perineal body (Pb) and genital hiatus (Gh) measurements and constipation, anal incontinence, severity of symptoms and quality of life. Methods The patients were distributed into two groups according to the posterior vaginal wall Bp point: one group with Bp <=-1 (without posterior vaginal wall prolapse, control group) and the other group with Bp >= 0 (with posterior vaginal wall prolapse, case group). Demographic data, defecatory dysfunction and SF-36 scores were compared between the groups. Correlations between severity of posterior prolapse (Bp, Gh, Pb and Gh + Pb) and severity of bowel symptoms were also calculated. Results A total of 613 women were evaluated, of whom 174 were included, 69 (39.7%) in the control group and 105 (60.3%) in the case group. The groups were similar in terms of anal incontinence, fecal urgency and/or constipation. There was no correlation between the severity of constipation and anal incontinence according to the Wexner score, and the severity of posterior vaginal wall prolapse measured in terms of point Bp. There were, however, statistically significant differences in Pb, Gh and Gh + Pb between the groups. The Pb and Gh + Pb measurements were positively correlated with symptoms of constipation, as well as with the scores of some SF-36 domains, but were not correlated with anal incontinence. Conclusions These results suggest that the severity of posterior vaginal wall prolapse is not correlated with constipation or anal incontinence, but Pb and Gh + Pb measurements are correlated with constipation and SF-36 scores.