sodium-ethylxanthate and Fecal-Incontinence

To define the prevalence of pelvic floor disorders in a non-institutionalised community and to determine the relationship to gender, age, parity and mode of delivery.. A representative population survey using the 1998 South Australian Health Omnibus Survey.. Random selection of 4400 households; 3010 interviews were conducted in the respondents' homes by trained female interviewers. This cross sectional survey included men and women aged 15-97 years.. The prevalence of all types of self-reported urinary incontinence in men was 4.4% and in women was 35.3% (P<0.001). Urinary incontinence was more commonly reported in nulliparous women than men and increased after pregnancy according to parity and age. The highest prevalence (51.9%) was reported in women aged 70-74 years. The prevalence of flatus and faecal incontinence was 6.8% and 2.3% in men and 10.9% and 3.5% in women, respectively. Pregnancy (> 20 weeks), regardless of the mode of delivery, greatly increased the prevalence of major pelvic floor dysfunction, defined as any type of incontinence, symptoms of prolapse or previous pelvic floor surgery. Multivariate logistic regression showed that, compared with nulliparity, pelvic floor dysfunction was significantly associated with caesarean section (OR 2.5, 95% CI 1.5-4.3), spontaneous vaginal delivery (OR 3.4, 95% CI 2.4-4.9) and at least one instrumental delivery (OR 4.3, 95% CI 2.8-6.6). The difference between caesarean and instrumental delivery was significant (P<0.03) but was not for caesarean and spontaneous delivery. Other associations with pelvic floor morbidity were age, body mass index, coughing, osteoporosis, arthritis and reduced quality of life scores. Symptoms of haemorrhoids also increased with age and parity and were reported in 19.9% of men and 30.2% of women.. Pelvic floor disorders are very common and are strongly associated with female gender, ageing, pregnancy, parity and instrumental delivery. Caesarean delivery is not associated with a significant reduction in long term pelvic floor morbidity compared with spontaneous vaginal delivery.

Topics: Adolescent; Adult; Age Distribution; Aged; Aged, 80 and over; Cross-Sectional Studies; Delivery, Obstetric; Fecal Incontinence; Female; Humans; Male; Middle Aged; Obstetric Labor Complications; Parity; Pelvic Floor; Pregnancy; Sex; Urinary Incontinence; Uterine Prolapse

The objective was to investigate how prostate cancer and its treatment affects sexual, urinary and bowel functions and to what extent eventual complications cause distress. A questionnaire was sent to 431 men aged 50-80 years with prostate cancer diagnosed in 1992 in the Stockholm area (Sweden) and 435 randomly selected men with a similar age distribution. Sexual function, as compared with their youth, was diminished in a majority of all men. The prostate cancer patients were, however, more likely to report low frequency and/or intensity in all aspects of sexual function. A majority of the men were distressed by a waning sexual capacity. The proportion of men with prostate cancer who were severely distressed owing to a decline in sexual function was larger than in the reference group. The willingness to trade off an intact sexual function for long-term survival varied considerably among the men in the reference group. Urinary and bowel symptoms were less common than a waning sexual function in both groups, and few appeared to be severely distressed by urinary or bowel symptoms. A decline in sexual functions was the most common cause of disease-specific distress in men with prostate cancer.

Topics: Aged; Attitude to Health; Constipation; Defecation; Ejaculation; Fecal Incontinence; Humans; Libido; Male; Middle Aged; Orgasm; Penile Erection; Prostatic Neoplasms; Radiography; Reference Values; Sex; Surveys and Questionnaires; Urinary Incontinence; Urination

The long-term outcome of Ivalon sponge rectopexy for rectal prolapse in a group of young patients was reviewed. Thirty-two patients under the age of 40 underwent Ivalon sponge rectopexy between 1961 and 1975 with no mortality and one early complication. Twenty-five patients (9 men; 16 women) aged 13-39 years (median 28 years) at the time of operation were interviewed and examined in the Out-Patient Department between 5 and 20 years (median 10 years) after the operation. Five (20 per cent) had developed recurrence which occurred at 1, 1, 5, 6 and 9 years. There was no significant change in bowel habit postoperatively, with the exception of 3 patients with diarrhoea who reverted to normal. There was some disturbance in faecal continence pre-operatively in 20 patients, of whom 15 (75 per cent) were improved by rectopexy. All patients had normal urinary and sexual function, and there was no disturbance of menstruation in females following rectopexy. Three men who wished to have children were successful. Three of six women who attempted to conceive post-operatively had normal pregnancies and deliveries. The three women who failed to do so had already been investigated for infertility before the operation. No patient developed pelvic malignancy.

Topics: Adolescent; Adult; Fecal Incontinence; Female; Fertility; Humans; Male; Polyvinyls; Postoperative Complications; Rectal Prolapse; Recurrence; Sex