St Mark's Hospital, London, UK.
Colorectal Dis. 2009 Nov;11(9):927-32. doi: 10.1111/j.1463-1318.2008.01717.x. Epub 2008 Oct 21.
The factors leading to faecal incontinence in males are less well understood than those in females. In this prospective study we aimed to compare the physiological, anatomical, psychological and behavioural characteristics of male and female patients presenting with symptoms of faecal incontinence.
One hundred and nine patients presenting with symptoms of faecal incontinence were studied. They underwent anorectal physiological studies, endoanal ultrasonography, and completed a St Mark's Incontinence Score, a locally developed pad questionnaire, a bowel symptom questionnaire, the Short Form 36 (SF-36) Health Survey questionnaire, the Hospital Anxiety and Depression Scale and the Maudsley Obsessive Compulsive Inventory.
Thirty-four men (mean age 59 years, SD 14 years, range 33-80) and 75 women (mean age 55 years, SD 15 years, range 21-86) participated in the study. Twenty-one patients (38% of men and 11% of women) had normal manometry and endoanal ultrasonography. There was no significant difference in the resting pressures of men compared with women, but men had significantly higher squeeze pressures. Rectal capacity was significantly higher in men but anal and rectal electrosensitivities were the same. Men placed a tissue at the anus more commonly than women while women were more likely to use a pad and to carry a spare pair of underwear around with them. Psychological profiles were very similar in the two sexes.
Nearly 40% of men with faecal incontinence report it in the absence of a definable functional or structural sphincter abnormality. There are differences in physiological characteristics and coping behaviours of men and women with faecal incontinence.
男性粪便失禁的原因不如女性那么清楚。在这项前瞻性研究中，我们旨在比较有粪便失禁症状的男性和女性患者的生理、解剖、心理和行为特征。
我们研究了 109 名有粪便失禁症状的患者。他们接受了肛门直肠生理研究、腔内超声检查，并完成了 St Mark 失禁评分、本地开发的垫问卷、肠症状问卷、简短表格 36（SF-36）健康调查问卷、医院焦虑和抑郁量表以及莫兹利强迫症量表。
34 名男性（平均年龄 59 岁，标准差 14 岁，范围 33-80）和 75 名女性（平均年龄 55 岁，标准差 15 岁，范围 21-86）参加了研究。21 名患者（38%的男性和 11%的女性）有正常的测压和腔内超声检查。男性的静息压力与女性相比没有显著差异，但男性的挤压压力明显较高。男性的直肠容量明显较高，但肛门和直肠的电敏感性相同。男性比女性更常见地将纸巾放在肛门处，而女性更有可能使用垫，并随身携带备用的内衣。两种性别的心理特征非常相似。
近 40%的有粪便失禁症状的男性报告在没有可定义的功能性或结构性括约肌异常的情况下发生。男性和女性在生理特征和应对行为方面存在差异。
