Exacerbation of symptom severity of pelvic floor disorders in women who report a history of sexual abuse.
Arch Surg
; 147(12): 1123-9, 2012 Dec.
Article
em En
| MEDLINE
| ID: mdl-23248015
ABSTRACT
OBJECTIVE:
To examine the effect of previous sexual abuse or assault (SAA) on symptom severity, quality of life, and physiologic measures in women with fecal incontinence or constipation.DESIGN:
A cross-sectional study of a prospectively maintained clinical database.SETTING:
A tertiary referral center for evaluation and physiologic testing for pelvic floor disorders. PATIENTS Women with fecal incontinence or constipation examined during a 6-year period. MAIN OUTCOMEMEASURES:
Symptom severity and quality of life were measured with the Fecal Incontinence Severity Index (FISI), Fecal Incontinence Quality of Life Scale (FIQL), Constipation Severity Instrument (CSI), Constipation-Related Quality of Life measure (CR-QOL), and 12-Item Short Form Health Survey (SF-12). Physiologic variables were ascertained with anorectal manometry, electromyography, and endoanal ultrasonography.RESULTS:
Of the 1781 women included, 213 (12.0%) reported SAA. These women were more likely to be white, to report a psychiatric illness, and to have a prior hysterectomy or episiotomy. On bivariate analysis, women with prior SAA had increased symptom severity on the FISI (P = .002) and CSI (P < .001) and diminished quality of life on the FIQL (P < .001), CR-QOL (P = .009), and SF-12 (P = .002 to P = .004). Physiologic variables did not differ significantly between patients with and without prior SAA.CONCLUSIONS:
A history of SAA significantly alters disease perception in fecal incontinence and constipation, but the disorders do not result from increased physiologic alterations. We must elicit a history of SAA in these patients, because the history may play a role in the discrepancy between symptom reporting and objective measurements and may modify treatment recommendations.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Delitos Sexuais
/
Constipação Intestinal
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Incontinência Fecal
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Distúrbios do Assoalho Pélvico
Tipo de estudo:
Diagnostic_studies
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Etiology_studies
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Guideline
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Observational_studies
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Prevalence_studies
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Qualitative_research
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Risk_factors_studies
Limite:
Adult
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Aged
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Female
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Humans
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Middle aged
Idioma:
En
Ano de publicação:
2012
Tipo de documento:
Article