Prevalence of Anal Incontinence in Women Attending Gynecological Outpatient Department

Abstract

Objective: To determine the frequency of anal incontinence among women visiting the gynecological outpatient department (OPD) of a tertiary care hospital.

Methodology: A cross-sectional study was conducted at the Gynecology OPD of Isra University Hospital, Hyderabad, from August 2024 to September 2025. Women aged 18–60 years with a history of at least one obstetric or gynecological procedure, including perineal tears, who attended the gynecological OPD were included. Patients were interviewed separately to ensure privacy and confidentiality. Detailed information regarding their previous medical and gynecological history, including obstetric procedures, gynecological surgeries, episiotomy, and perineal injuries, was obtained. Patients were specifically questioned about involuntary loss of fecal matter, including solid stool, liquid stool, and gas, as well as their ability to control leakage, to assess the presence of anal incontinence. Relevant data were entered and analyzed using SPSS version 26.

Results: The overall mean age of the women was 43.74 ± 13.67 years, and the mean BMI was 25.55 ± 3.49 kg/m². The majority of women were housewives (70.3%). The overall prevalence of anal incontinence was 8.1%. Anal incontinence was significantly associated with advanced age, increased BMI, instrumental vaginal delivery, episiotomy, perineal tears, and hysterectomy (p < 0.05), whereas cesarean section appeared to have a protective effect. These findings highlight obstetric trauma and pelvic floor weakening as important contributors to anal incontinence.

Conclusion: The study revealed that anal incontinence is a relatively uncommon but clinically significant condition among women attending the gynecological OPD, with an overall prevalence of approximately 8.1%. However, referral bias inherent to this facility, which serves as a major center for pelvic floor disorders, may have influenced the observed prevalence.