Case Control Study
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World J Gastroenterol. Jun 28, 2014; 20(24): 7933-7940
Published online Jun 28, 2014. doi: 10.3748/wjg.v20.i24.7933
Fecal incontinence in men: Causes and clinical and manometric features
Teresa Muñoz-Yagüe, Pablo Solís-Muñoz, Constanza Ciriza de los Ríos, Francisco Muñoz-Garrido, Jesús Vara, José Antonio Solís-Herruzo
Teresa Muñoz-Yagüe, Constanza Ciriza de los Ríos, Department of Gastroenterology, the University Hospital “12 de Octubre”, 28041-Madrid, Spain
Pablo Solís-Muñoz, Institute of Liver Studies, King’s College Hospital, London SE5 9RS, United Kingdom
Francisco Muñoz-Garrido, Jesús Vara, Pelvic Floor Unit, the University Hospital “12 de Octubre”, 28041-Madrid, Spain
José Antonio Solís-Herruzo, Research Center, University Hospital “12 de Octubre”, Complutense University, 28041-Madrid, Spain
Author contributions: Muñoz-Yagüe T and Solís-Muñoz P contributed to the study concept and design; acquisition of data; analysis and interpretation of data; drafting of the manuscript; critical revision of the manuscript for important intellectual content; study supervision; Ciriza de los Rios C, Muñoz-Garrido F and Vara J contributed to the acquisition, analysis, and interpretation of data; and critical revision of the manuscript for important intellectual content; Solís-Herruzo JA contributed to the study concept and design, statistical analysis, critical revision of the manuscript for important intellectual content, study supervision.
Supported by Grants from “Fundación Mutua Madrileña”, No. AP11223-2013 and No. AP8540-2011, Madrid, Spain
Correspondence to: Teresa Muñoz-Yagüe, PhD, MD, Professor, Department of Gastroenterology, the University Hospital “12 de Octubre”, Avenida de Cordoba, S/N. 28041-Madrid, Spain. tmunoz.hdoc@salud.madrid.org
Telephone: +34-91-3908829 Fax: +34-91-3908544
Received: November 22, 2013
Revised: February 16, 2014
Accepted: April 5, 2014
Published online: June 28, 2014
Processing time: 217 Days and 8.9 Hours
Abstract

AIM: To determine the causes and characteristics of fecal incontinence in men and to compare these features with those presented by a group of women with the same problem.

METHODS: We analyzed the medical history, clinical and manometric data from 119 men with fecal incontinence studied in our unit and compared these data with those obtained from 645 women studied for the same problem. Response to treatment was evaluated after 6 mo of follow-up.

RESULTS: Fifteen percent of patients studied in our unit for fecal incontinence were male. Men took longer than women before asking for medical help. Ano-rectal surgery was the most common risk factor for men related to fecal incontinence. Chronic diarrhea was present in more than 40% of patients in both groups. Decreased resting and external anal sphincter pressures were more frequent in women. No significant differences existed between the sexes regarding rectal sensitivity and recto-anal inhibitory reflex. In 17.8% of men, all presenting soiling, manometric findings did not justify fecal incontinence. Response to treatment was good in both groups, as 80.4% of patients improved and fecal incontinence disappeared in 13.2% of them.

CONCLUSION: In our series, it was common that men waited longer in seeking medical help for fecal incontinence. Ano-rectal surgery was the major cause of this problem. Chronic diarrhea was a predisposing factor in both sexes. Manometric differences between groups were limited to an increased frequency of hypotony of the external anal sphincter in women. Fecal incontinence was controllable in most patients.

Keywords: Fecal Incontinence; Gender; Ano-rectal surgery; Ano-rectal manometry; Treatment; Biofeedback

Core tip: In our series of 119 men and 645 women with fecal incontinence, it was common that men waited longer in seeking medical help for fecal incontinence. Ano-rectal surgery was the major cause of this problem in men. Diarrhea was a predisposing factor in both sexes. Manometric differences between groups were limited to an increased frequency of hypotony of the external anal sphincter in women. Fecal incontinence was controllable in most patients.