Prevalence of Anal Incontinence in Women Attending Gynecological Outpatient Department

Abstract

Objective: To determine the frequency of anal incontinence among women who visiting the
gynecological OPD at a tertiary care Hospital.
Material and methods: This descriptive study was conducted on 375 women attending the
gynecological outpatient department at Isra university Hospital Hyderabad. Women aged 18 years and
above presenting to the gynecological OPD were included. A structured validated questionnaire was
used to assess the frequency, severity, and type of anal incontinence (flatus, liquid, solid stool).
Severity was graded using the Wexner Continence Grading Scale. Demographic variables including
age, parity, mode of delivery, BMI, menopausal status, and obstetric history were recorded. Data were
stratified by age groups, parity, and menopausal status, using SPSS version 23, with significance level
at p<0.05.
Results: Overall prevalence of anal incontinence was 34.7% (n=130). Flatus incontinence was most
prevalent (21.6%), followed by liquid stool incontinence (16.8%) and solid stool incontinence (8.3%).
Mean Wexner score was 8.3 ± 3.6 among affected patients. Stratification revealed significantly higher
prevalence in women above 50 years (54.2%) (p<0.001), grand multiparous women (parity ≥5)
demonstrating 2.8 times higher odds compared to nulliparous women (OR=2.8, 95% CI: 1.6–4.9;
p<0.001). Vaginal delivery was also identified as a significant risk factor compared to cesarean section
(48.3% vs. 19.4%; p<0.001). Overall advancing age (p<0.001), vaginal delivery (p<0.001), grand
multiparity (p=0.002), and menopausal status (p=0.003) were identified as independent predictors of
anal incontinence.
Conclusion: Anal incontinence is a considerably prevalent yet underreported condition among women
attending gynecological outpatient services in our population. Advancing age, vaginal delivery, grand
multiparity, instrumental delivery, and postmenopausal status were identified as significant
independent risk factors.
Keywords: Anal incontinence, fecal incontinence, women, gynecological outpatient, prevalence,
pelvic floor dysfunction, vaginal delivery, multiparity.