Urinary incontinence (UI) and fecal incontinence (FI) are debilitating conditions affecting patients’ quality of life (QOL). Dual incontinence (DI) of both urine and stool represents an additional burden. We compare the physical and mental health of patients with UI, FI, and DI. We hypothesize that the presence of DI is associated with increased psychosocial burden than UI or FI alone.
Patients were recruited via an online registry ResearchMatch, to complete questionnaires on sociodemographics, urinary and bowel symptoms and psychosocial comorbidity. The Patient-Reported Outcomes Measurement Information System (PROMIS) measures for physical and mental health, anxiety, depression, stress, and instrumental support were used to assess psychosocial burden. Depression was assessed using one question to avoid redundancy. Responses including PROMIS measures were compared between those with no incontinence, UI, FI, and DI.
4117 respondents completed the study; majority of which are female (77%), and white, non-Hispanic (82%). Age and BMI are statistically different between groups, with the DI group having the oldest mean age (55 years) and highest mean BMI (29 kg/m2).Those with any type of incontinence had lower levels of educational attrition, were more often retired or on disability, and less often reported using private insurance as compared to those with no incontinence. PROMIS scores were significantly different across all groups (Table 1), with DI having the lowest physical and mental health scores (i.e. poorest health), and highest stress and depression scores (i.e. greatest burden). Compared to no incontinence, those with DI had significantly worse physical and mental health, and worse scores on all psychosocial measures. When comparing those with DI and those with UI or FI only, the results remained different between UI and DI groups but were similar in the FI and DI groups for most measures, suggesting this burden may be largely driven by FI over UI.
DI results in worse patient-reported physical and mental health, and higher psychosocial burden. In our cohort, it appears the psychosocial burden may be largely driven by the FI component of DI. Thus, addressing FI in our patients with DI may help improve QOL.
