Written versus oral disclosure of fecal and urinary incontinence in women with dual incontinence.

introduction and hypothesisTo compare fecal incontinence (FI) and urinary incontinence (UI) disclosure in women with dual incontinence (DI), and to assess UI disclosure in DI subjects compared with women with UI alone. We hypothesized that women with DI would be less likely to disclose FI in comparison to UI and as likely to disclose UI as women with UI alone.

methodsWe performed a retrospective chart review of new patient visits to an academic urogynecology clinic from 2007 to 2011. Clinical records were reviewed; demographic data and responses to the Incontinence Severity Index (ISI) and Wexner scales were recorded. Patients' written responses to the ISI and Wexner were compared with the diagnoses obtained from the oral history by the physician.

resultsOf 1,899 women in the database, 557 women were diagnosed with DI and 447 women were diagnosed with UI alone. Women with DI were less likely to orally disclose FI than UI (135 out of 557 [23 %], vs 485 out of 557 [87 %], p < 0.001), but were as likely as women with UI alone to disclose UI (385 out of 447 [86 %] vs 485 out of 557 [87 %], p = 0.66). In the multivariate analysis, DI subjects had greater odds of disclosing FI to their physicians if they had private insurance (OR 1.9, 95 %CI 1.2, 3.0) or Wexner score >7 (OR 9.0, 95 % CI 5.4,14.8) and lower ISI score (OR 1.5, CI 1.4, 1.6).

conclusionsWomen with DI were less likely to report FI in comparison to UI. Patients were more likely to orally report FI when the symptoms were severe.