Lower urinary tract symptoms in chronically constipated women

The prevalence of lower urinary tract symptoms (LUTS) is as high as 66 % in the general population. Constipation rates of >30 % were reported among women with LUTS. We examined the association of chronic constipation to the occurrence of LUTS and, in particular, the relationship of LUTS to the type of constipation. We also examined the prevalence and association of pelvic organ prolapse (POP) to LUTS.

In a retrospective survey of data collected on patients referred to our clinic during 2008-2009 for assessment of chronic constipation, 161 constipated women and 162 healthy female volunteers completed a structured questionnaire of urinary and bowel habits components (BBUS-Q22), the constipation scoring system for assessment of constipation severity and the Rome III component for IBS and chronic constipation. The constipated group underwent dynamic transperineal ultrasound.

Demographic data was similar in both groups. LUTS were more common in the constipated group (increased urinary frequency 34 % vs. 14 %, p < 0.001, nocturia 31 % vs. 8 %, p < 0.001, urinary urgency 53 % vs. 21 %, p < 0.001, incomplete urinary emptying 24 % vs. 9 %, p = 0.003 and urinary incontinence 21 % vs. 5 %, p < 0.0001). Urinary symptoms did not vary between IBS and functional constipation. In addition, the occurrence of urinary symptoms was unrelated to the diagnosis of posterior pelvic organ prolapse (POP) in the constipated group.

LUTS are common in constipated women, but are unrelated to the type of constipation. These findings may suggest that the constipation process may have a direct contribution to the occurrence of LUTS.