The Association Between Parity and Fecal Problems Differs by Urinary Status

Importance Urinary incontinence, fecal incontinence, and constipation frequently manifest and are risk factors for one another. Studies investigating the association between parity and fecal problems in urinary continent and urinary incontinent women are lacking. Objectives The aim of this study was to examine whether the association between parity and fecal problems differs in urinary continent and urinary incontinent women. Study Design This study was a cross-sectional, retrospective questionnaire-based study. The population was a representation of the general Dutch female population (n = 5,670), including nulliparous (n = 2,790) and parous women (n = 2,880). Data were collected using the Groningen Defecation and Fecal Continence questionnaire, addressing urinary and fecal problems according to validated criteria. Parametric test, χ² test, Fisher exact test, and univariable and multivariable logistic regression analyses were used. Results Of the urinary incontinent women, 13.7% nulliparous and 6.3% parous women reported a combination of fecal incontinence with constipation. This made urinary incontinent nulliparous women 1.90 times more prone to have both fecal incontinence and constipation (P < 0.001), especially nulliparous women with stress urinary incontinence (odds ratio, 2.76; 95% confidence interval, 1.44-5.31; P = 0.002). In the urinary continent women, nulliparous women reported significantly more often fecal incontinence as a solitary problem than parous women (4.3% vs 2.5%; P = 0.016; odds ratio, 1.73; 95% confidence interval, 1.06-2.81; P = 0.028). Conclusions The association between parity and fecal problems is different in urinary continent and incontinent women. In urinary incontinent women, especially with stress urinary incontinence, nulliparous women experience more often the coexistence of fecal incontinence and constipation than parous women. In urinary continent women, nulliparous women had more frequently a solitary problem of fecal incontinence than parous women.