Matsushima Sayuri, Kuromizu Joji, Miyajima Nobuyoshi, Beniya Ayumi, Hikosaka Yoshioki, Kono Yoichi, Katori Remi, Matsumura Naomi, Fukano Masahiko, Okamoto Kosuke, Shimojima Yasuhiro, Matsushima Makoto
Matsushima Hospital Proctology Center, Yokohama, Japan.
J Anus Rectum Colon. 2022 Oct 27;6(4):274-281. doi: 10.23922/jarc.2022-008. eCollection 2022.
Although community studies have shown no difference between the sexes in the prevalence of fecal incontinence (FI), few direct comparisons of disease characteristics between male and female patients have been reported. The aim of this study was to determine whether characteristics of FI differ between male and female patients in Japan.
Included in the study were 408 (149 men, 259 women) patients with FI who visited the Matsushima Hospital Coloproctology Center between October 2016 and September 2017. We retrospectively evaluated data on age, number of bowel movements, Bristol stool form scale, number of FI, incontinence scores, anorectal manometry, comorbidities, and history of anal surgery.
Maximum resting pressure and maximum squeeze pressure were found to be within normal range in significantly more male than female patients (34.9% vs. 12.4%, respectively; p < 0.0001). Irritable bowel syndrome (IBS, 20.1% vs. 9.3%; p = 0.003) and a history of anal surgery (29.5% vs. 17.5%; p = 0.02) were more prevalent among male patients than among female patients. Use of mepenzolate as treatment was significantly more common among male patients than among female patients (16.8% vs. 6.6%, respectively; p = 0.005). Responses to the various treatments were good, regardless of sex.
FI appears to be more commonly accompanied by normal anal sphincter pressures in male patients than in female patients, and IBS and previous anal surgery appear to be more common among male patients than among female patients. FI appears to be controllable in most patients, regardless of sex.
尽管社区研究表明，粪失禁（FI）的患病率在性别上并无差异，但鲜有关于男性和女性患者疾病特征的直接比较报道。本研究旨在确定在日本，男性和女性粪失禁患者的特征是否存在差异。
本研究纳入了2016年10月至2017年9月期间就诊于松岛医院结直肠外科中心的408例粪失禁患者（149例男性，259例女性）。我们回顾性评估了患者的年龄、排便次数、布里斯托大便形态量表、粪失禁次数、失禁评分、肛门直肠测压、合并症以及肛门手术史等数据。
发现最大静息压力和最大收缩压力在正常范围内的男性患者明显多于女性患者（分别为34.9%和12.4%；p<0.0001）。男性患者中肠易激综合征（IBS，20.1%对9.3%；p = 0.003）和肛门手术史（29.5%对17.5%；p = 0.02）的患病率高于女性患者。男性患者使用美哌佐酯进行治疗的情况明显比女性患者更为常见（分别为16.8%和6.6%；p = 0.005）。无论性别如何，各种治疗的反应都良好。
与女性患者相比，男性粪失禁患者似乎更常伴有正常的肛门括约肌压力，而且男性患者中肠易激综合征和既往肛门手术似乎比女性患者更常见。无论性别如何，大多数患者的粪失禁似乎都是可控的。
