Wasserberg Nir, Haney Mark, Petrone Patrizio, Crookes Peter, Rosca Jason, Ritter Manfred, Kaufman Howard S
Division of Colorectal and Pelvic Floor Surgery, Department of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA.
Int J Colorectal Dis. 2008 May;23(5):493-7. doi: 10.1007/s00384-007-0432-6. Epub 2008 Jan 29.
Morbid obesity is associated with urinary incontinence (UI). The study purpose was to determine the prevalence of fecal incontinence (FI), its associated risk factors, and its impact on quality of life (QOL) in morbidly obese women.
A questionnaire-based study on morbidly obese women [body mass index (BMI)>or=35 m/kg2], attending a bariatric surgery seminar, was conducted. Data included demographics, past medical, surgical and obstetric history, and obesity-related co-morbidities. Patients who reported of FI, completed the Cleveland Clinic Foundation Fecal Incontinence scale (CCF-FI) and the Fecal Incontinence Quality of Life scale (FIQL).
Participants included 256 women [median age 45 years (19-70)] and mean BMI of 49.3+/-9.4 m/kg2. FI was reported in 63%. History of obstetric injury (OR: 2.4, 95% CI: 1.33-4.3; p<0.001) and UI (OR: 1.2, 95% CI: 1.1-1.4; p<0.001) were significantly associated with FI. There was no association with age, BMI, parity, and presence of diabetes or hypertension. Median CCF-FI score was 7 (1-20); 34.5% scored>or=10. Incontinence for gas was the most frequent type (87%) of FI, followed by incontinence for liquids (80%), which also had the highest impact on QOL (p<0.01). Mean FIQL scores were >3 for all four domains studied. CCF-FI scores were significantly correlated with FIQL scores in all domains (p=0.02).
The prevalence of FI among morbidly obese women may be much higher than the rates reported in the general population. FI has adverse effects on QOL. Its correlation with UI suggests that morbid obesity may pose a risk of global pelvic floor dysfunction.
病态肥胖与尿失禁（UI）相关。本研究旨在确定病态肥胖女性中粪便失禁（FI）的患病率、相关危险因素及其对生活质量（QOL）的影响。
对参加减肥手术研讨会的病态肥胖女性[体重指数（BMI）≥35m/kg²]进行了一项基于问卷的研究。数据包括人口统计学、既往病史、手术史和产科病史以及肥胖相关的合并症。报告有FI的患者完成了克利夫兰诊所基金会粪便失禁量表（CCF-FI）和粪便失禁生活质量量表（FIQL）。
参与者包括256名女性[中位年龄45岁（19 - 70岁）]，平均BMI为49.3±9.4m/kg²。63%的人报告有FI。产科损伤史（OR：2.4，95%CI：1.33 - 4.3；p<0.001）和UI（OR：1.2，95%CI：1.1 - 1.4；p<0.001）与FI显著相关。与年龄、BMI、产次以及糖尿病或高血压的存在无关。CCF-FI中位评分为7（1 - 20）；34.5%的评分≥10。气体失禁是最常见的FI类型（87%），其次是液体失禁（80%），液体失禁对生活质量的影响也最大（p<0.01）。在所有四个研究领域中，FIQL平均得分均>3。CCF-FI评分在所有领域均与FIQL评分显著相关（p = 0.02）。
病态肥胖女性中FI的患病率可能远高于普通人群报告的患病率。FI对生活质量有不利影响。它与UI的相关性表明，病态肥胖可能带来全球盆底功能障碍的风险。
