Anal Intercourse and Fecal Incontinence: Evidence from the 2009-2010 National Health and Nutrition Examination Survey

OBJECTIVES:

The aim of this study was to assess the prevalence and associations between anal intercourse and fecal incontinence.

METHODS:

Analyses were based on data from 6,150 adults (≥20 years) from the 2009-2010 cycle of the National Health and Nutrition Examination Surveys. Fecal incontinence was defined as the loss of liquid, solid, or mucus stool occurring at least monthly on a validated questionnaire. A gender-specific sexual behavior questionnaire assessed any anal intercourse via an audio computer-assisted personal interview. Co-variables included: age, race, education, poverty income ratio, body mass index, chronic illnesses, depression, loose stool consistency (Bristol Stool Scale types 6 or 7), and reproductive variables in women. Prevalence estimates and prevalence odds ratios (PORs) were analyzed in adjusted multivariable models using appropriate sampling weights.

RESULTS:

Overall, 4,170 adults aged 20-69 years (2,070 women and 2,100 men) completed sexual behavior questionnaires and responded to fecal incontinence questions. Anal intercourse was higher among women (37.3%) than men (4.5%), P<0.001. Fecal incontinence rates were higher among women (9.9 vs. 7.4%, P=0.05) and men (11.6 vs. 5.3%, P=0.03) reporting anal intercourse compared with those not reporting anal intercourse. After multivariable adjustment for other factors associated with fecal incontinence, anal intercourse remained a predictor of fecal incontinence among women (POR: 1.5; 95% confidence interval (CI): 1.0-2.0) and men (POR: 2.8; 95% CI: 1.6-5.0).

CONCLUSIONS:

The findings support the assessment of anal intercourse as a factor contributing to fecal incontinence in adults, especially among men.

Purchase full article at:   http://goo.gl/AhM2D1

By:  Markland AD1,2,3, Dunivan GC4, Vaughan CP1,5, Rogers RG4.

• 1Birmingham Geriatric Research, Education, and Clinical Center, Department of Veterans Affairs Medical Center, Birmingham, Alabama, USA.
• 2Atlanta Geriatric Research, Education, and Clinical Center, Department of Veterans Affairs Medical Center, Atlanta, Georgia, USA.
• 3Department of Medicine, Division of Gerontology, Geriatrics, and Palliative Care, UAB Center for Aging, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.
• 4Department of Obstetrics and Gynecology, Division of Urogynecology, University of New Mexico, Albuquerque, New Mexico, USA.
• 5Department of Medicine, Division of General Medicine and Geriatrics, Emory University, Atlanta, Georgia, USA.
• Am J Gastroenterol. 2016 Jan 12. doi: 10.1038/ajg.2015.419 

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Living with Constant Leaking of Urine & Odour: Thematic Analysis of Socio-Cultural Experiences of Women Affected by Obstetric Fistula in Rural Tanzania

Background

Obstetric fistula is a worldwide problem that affects women and girls mostly in Sub Saharan Africa. It is a devastating medical condition consisting of an abnormal opening between the vagina and the bladder or rectum, resulting from unrelieved obstructed labour. Obstetric fistula has devastating social, economic and psychological effect on the health and wellbeing of the women living with it. This study aimed at exploring social-cultural experiences of women living with obstetric fistula in rural Tanzania.

Methods

Women living with obstetric fistula were identified from the fistula ward at CCBRT hospital. Sixteen individual semi structured interviews and two (2) focus group discussions were conducted among consenting women. Interviews were transcribed verbatim and transcripts analysed independently by two researchers using a thematic analysis approach. Themes related to the experiences of living with obstetric fistula were identified.

Results

Four themes illustrating the socio-cultural experiences of women living with obstetric fistula emerged from the analysis of women experiences of living with incontinence and odour. These were keeping clean and neat, earning an income, maintaining marriage, and keeping association. Women experiences of living with fistula were largely influenced by perceptions of people around them basing on their cultural understanding of a woman.

Conclusion

Living with fistula reveals women’s day-to-day experiences of social discrimination and loss of control due to incontinence and odour. They cannot work and contribute to the family income, cannot satisfy their husband’s sexual needs and or bear children, and cannot interact with members of the community in social activities. Women experience of living with fistula was influenced by perceptions of people around them. In the eyes of these people, women who leak urine were of less value since they were not capable of carrying out ascribed social roles.

Below:  Women’s socio-cultural experience

Full article at:   http://goo.gl/xzIr1d

By:  Lilian T. Mselle^1* and Thecla W. Kohi²

¹Department of Clinical Nursing, Muhimbili University of Health and Allied Sciences, Dar es Salaam, PO Box 65004, Tanzania

²Department of Nursing Management, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania

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