Abstract
Aim
Faecal incontinence and constipation are common conditions which may adversely affect quality of life. They may have an adverse effect on sexual function.
Method
This review of the published literature aimed to assess the published evidence.
Results
Only seven published studies have reported the effect of these conditions on sexual function. Four reported on those with faecal incontinence. Two reported on those with faecal incontinence and constipation and one reported solely on constipation. All were questionnaire-based studies or retrospective reviews of institutional databases. A heterogenous mix of different measures of sexual function were applied. Conflicting findings were reported. Some studies suggested that those with faecal incontinence and constipation may have adverse sexual experiences. Others suggest that these pelvic floor disorders have no significant effect.
Conclusion
Further work is needed to investigate this. Large questionnaire studies with normal subject controls and adjustment for confounding factors are likely to be needed.
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References
Nelson R, Norton N, Cautley E, Furner S (1995) Community-based prevalence of anal incontinence. JAMA 274(7):559–561
Stewart WF, Liberman JN, Sandler RS, Woods MS, Stemhagen A, Chee E, Lipton RB, Farup CE (1999) Epidemiology of constipation (EPOC) study in the United States: relation of clinical subtypes to sociodemographic features. Am J Gastroenterol 94(12):3530–3540
McCool-Myers M, Theurich M, Zuelke A, Knuettel H, Apfelbacher C (2018) Predictors of female sexual dysfunction: a systematic review and qualitative analysis through gender inequality paradigms. BMC Womens Health 18(1):108
Pellino G, Ramage L, Simillis C, Warren O, Kontovounisios C, Tan E, Tekkis P (2017) Evaluation of sexual dysfunction in female patients presenting with faecal incontinence or defecation disorder. Int J Color Dis 32(5):667–674
Imhoff LR, Brown JS, Creasman JM, Subak LL, Van den Eeden SK, Thom DH et al (2012) Fecal incontinence decreases sexual quality of life, but does not prevent sexual activity in women. Dis Colon Rectum 55(10):1059–1065
Rockwood TH, Church JM, Fleshman JW, Kane RL, Mavrantonis C, Thorson AG, Wexner SD, Bliss D, Lowry AC (1999) Patient and surgeon ranking of the severity of symptoms associated with fecal incontinence: the fecal incontinence severity index. Dis Colon Rectum 42(12):1525–1532
Rosen R, Brown C, Heiman J, Leiblum S, Meston C, Shabsigh R et al (2000) The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital Ther 26(2):191–208
Fashokun TB, Harvie HS, Schimpf MO, Olivera CK, Epstein LB, Jean-Michel M et al (2013) Sexual activity and function in women with and without pelvic floor disorders. Int Urogynecol J 24(1):91–97
Cichowski SB, Komesu YM, Dunivan GC, Rogers RG (2013) The association between fecal incontinence and sexual activity and function in women attending a tertiary referral center. Int Urogynecol J 24(9):1489–1494
Jorge JM, Wexner SD (1993) Etiology and management of fecal incontinence. Dis Colon Rectum 36(1):77–97
Pauls RN, Rogers RG, Parekh M, Pitkin J, Kammerer-Doak D, Sand P (2015) Sexual function in women with anal incontinence using a new instrument: the PISQ-IR. Int Urogynecol J 26(5):657–663
Bortolami A, Vanti C, Banchelli F, Guccione AA, Pillastrini P (2015) Relationship between female pelvic floor dysfunction and sexual dysfunction: an observational study. J Sex Med 12(5):1233–1241
Li-Yun-Fong RJ, Larouche M, Hyakutake M, Koenig N, Lovatt C, Geoffrion R, Brotto LA, Lee T, Cundiff GW (2017) Is pelvic floor dysfunction an independent threat to sexual function? A cross-sectional study in women with pelvic floor dysfunction. J Sex Med 14(2):226–237
Philips EM, Peeters B, Teeuw AH, Leenders AG, Boluyt N, Brilleslijper-Kater SN et al (2015) Stressful life events in children with functional defecation disorders. J Pediatr Gastroenterol Nutr 61(4):384–392
Devanarayana NM, Rajindrajith S, Pathmeswaran A, Abegunasekara C, Gunawardena NK, Benninga MA (2015) Epidemiology of irritable bowel syndrome in children and adolescents in Asia. J Pediatr Gastroenterol Nutr 60(6):792–798
Pulverman CS, Kilimnik CD, Meston CM (2018) The impact of childhood sexual abuse on women’s sexual health: a comprehensive review. Sex Med Rev 6(2):188–200
Emmertsen KJ, Laurberg S (2012) Low anterior resection syndrome score: development and validation of a symptom-based scoring system for bowel dysfunction after low anterior resection for rectal cancer. Ann Surg 255(5):922–928
Juul T, Ahlberg M, Biondo S, Espin E, Jimenez LM, Matzel KE, Palmer GJ, Sauermann A, Trenti L, Zhang W, Laurberg S, Christensen P (2014) Low anterior resection syndrome and quality of life: an international multicenter study. Dis Colon Rectum 57(5):585–591
Riss S, Stift A, Teleky B, Rieder E, Mittlbock M, Maier A et al (2009) Long-term anorectal and sexual function after overlapping anterior anal sphincter repair: a case-match study. Dis Colon Rectum 52(6):1095–1100
Jadav AM, Wadhawan H, Jones GL, Wheldon LW, Radley SC, Brown SR (2013) Does sacral nerve stimulation improve global pelvic function in women? Color Dis 15(7):848–857
Wong MT, Abet E, Rigaud J, Frampas E, Lehur PA, Meurette G (2011) Minimally invasive ventral mesh rectopexy for complex rectocoele: impact on anorectal and sexual function. Color Dis 13(10):e320–e326
Formijne Jonkers HA, Poierrie N, Draaisma WA, Broeders IA, Consten EC (2013) Impact of rectopexy on sexual function: a cohort analysis. Int J Color Dis 28(11):1579–1582
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What does this paper add to the literature:
This is the first published review of the effect of faecal and flatus incontinence and constipation on sexual function. This highlights a significant problem which is often overlooked.
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Thomas, G.P., Maeda, Y. & Vaizey, C.J. A review of the effect of faecal incontinence and constipation on sexual function. Int J Colorectal Dis 34, 387–391 (2019). https://doi.org/10.1007/s00384-018-03231-9
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DOI: https://doi.org/10.1007/s00384-018-03231-9