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This study aims to verify the results from our previous retrospective cohort analysis by establishing a database of well-characterised patients prospectively. The different prevalence of neurological disorders, abdominal, urological and obstetrical surgery, diarrhoea and other potential associated factors as well as the importance of abnormalities identified by 3D high resolution anorectal manometry (HARM) will be compared between subjects with feacal incontinence (FI), double incontinence (DI) and controls. Presence and severity of both FI and urinary incontinence (UI) will be evaluated by disease specific questionnaires. Measuring both disease severity and Quality of Life (QoL) is needed to determine the true impact of incontinence. Finally, the impact on quality of life will be compared between both groups.
Double incontinence (DI) is the concomitant incontinence for urine and stool. A 3 - 5 % prevalence among adults has been reported, while 7 - 18 % of community-dwelling adults suffer from faecal incontinence (FI), irrespective of gender. Risk factors for FI include structural anomalies of the anorectal region, disturbed rectal compliance, disturbed anorectal sensation and presence of diarrhoea. Age, body mass index (BMI), obstetrical history (especially parity), anal penetrative intercourse and chronic illness have also been implicated. In contrast, little is known about the pathophysiology of DI. Factors like older age, multiparity, neurological disease and medical comorbidities have been proposed based on analysis from the Nurse's health study. According to our recent retrospective cohort analysis (accepted for publication Acta Gastro-Enterologica Belgica), diarrhoea, neurological disease and previous urological interventions characterise patients suffering from DI. Males most frequently suffer from an underlying neurologic disorder, while anatomical anomalies and urological surgery was more frequently observed in women. There was a trend toward more frequent diarrhoea in both genders. Anorectal manometry parameters could not differentiate between FI alone or DI. However, this result could have been hampered by the use of conventional manometry in contrast to high-resolution 3D manometry.
This study aims to verify the results from our previous retrospective cohort analysis by establishing a database of well-characterised patients prospectively. The different prevalence of neurological disorders, abdominal, urological and obstetrical surgery, diarrhoea and other potential associated factors as well as the importance of abnormalities identified by 3D high resolution anorectal manometry (HARM) will be compared between subjects with FI, DI and controls. Presence and severity of both FI and UI will be evaluated by disease specific questionnaires.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Double incontinence |
| ||
| faecal incontinence |
| ||
| controls |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Questionnaires | Other | Disease specific questionnaires |
|
| Measure | Description | Time Frame |
|---|---|---|
| compose a database of patients suffering from faecal or double incontinence | a database will be created | during inclusion visit |
| Measure | Description | Time Frame |
|---|---|---|
| Confirm the role of diarrhea as a major determinant of double incontinence vs faecal incontinence | this outcome will be assessed using jorge and wexner score | during inclusion visit |
| Confirm the role of diarrhea as a major determinant of double incontinence vs faecal incontinence |
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Inclusion Criteria:
Exclusion Criteria:
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All patients referred for HARM for FI are eligible to enroll in the database.
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Magali Surmont | Contact | +32 2 477 60 11 | magali.surmont@uzbrussel.be | |
| Virgini Van Buggenhout | Contact | +32 2 477 60 11 | virgini.vanbuggenhout@uzbrussel.be |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| UZ Brussel | Recruiting | Brussels | Brussels Capital | 1090 | Belgium |
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this outcome will be assessed using vaizey score |
| during inclusion visit |
| Confirm the role of diarrhea as a major determinant of double incontinence vs faecal incontinence | this outcome will be assessed using International consultation on incontinence questionnaire | during inclusion visit |
| Confirm the role of diarrhea as a major determinant of double incontinence vs faecal incontinence | this outcome will be assessed using clinical frailty score | during inclusion visit |
| Confirm the role of diarrhea as a major determinant of double incontinence vs faecal incontinence | this outcome will be assessed using bristol stool scale | during inclusion visit |
| Identify other factors associated with DI vs. FI , | this outcome will be assessed using bristol stool scale | during inclusion visit |
| Identify other factors associated with DI vs. FI , | this outcome will be assessed using clinical frailty score | during inclusion visit |
| Identify other factors associated with DI vs. FI , | this outcome will be assessed using jorge and wexner score | during inclusion visit |
| Identify other factors associated with DI vs. FI , | this outcome will be assessed using vaizey score | during inclusion visit |
| Identify other factors associated with DI vs. FI , | this outcome will be assessed using International consultation on incontinence questionnaire | during inclusion visit |
| Compare manometric data from HARM in DI vs. FI alone; | this outcome will be assessed using HARM | during inclusion visit |
| Assess the prevalence of DI in women and men with FI presenting for HARM; | this outcome will be assessed using HARM | during inclusion visit |
| Investigate the impact of UI on the quality of life in DI vs. FI alone. | this outcome will be assessed using the Quality of Life questionnaire (faecal incontinence Quality of Life scale) | during inclusion visit |
| ID | Term |
|---|---|
| D004688 | Encopresis |
| D014549 | Urinary Incontinence |
| ID | Term |
|---|---|
| D012817 | Signs and Symptoms, Digestive |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D001526 | Behavioral Symptoms |
| D001519 | Behavior |
| D019960 | Elimination Disorders |
| D001523 | Mental Disorders |
| D014555 | Urination Disorders |
| D014570 | Urologic Diseases |
| D052776 | Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D052801 | Male Urogenital Diseases |
| D059411 | Lower Urinary Tract Symptoms |
| D020924 | Urological Manifestations |
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| ID | Term |
|---|---|
| D011795 | Surveys and Questionnaires |
| ID | Term |
|---|---|
| D003625 | Data Collection |
| D004812 | Epidemiologic Methods |
| D008919 | Investigative Techniques |
| D017531 | Health Care Evaluation Mechanisms |
| D011787 | Quality of Health Care |
| D017530 | Health Care Quality, Access, and Evaluation |
| D011634 | Public Health |
| D004778 | Environment and Public Health |
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