(Poster 130) Patient Factors and Prevalence of FI When Presenting for OAB

Objectives: To identify the prevalence and patient factors associated with the report of FI in patients presenting with OAB.

Methods: We performed a retrospective cohort study of patients in an academic Urogynecology practice. Patients were included if they were at least 18 years old and presenting for evaluation of overactive bladder (OAB) symptoms from January 2022 to December 2023. Among this cohort, we identified patients who presented with fecal incontinence (FI) based on Pelvic Floor Distress Inventory-20 (PFDI-20) question 9 (“Do you usually lose stool beyond your control if your stool is well formed?”). We collected baseline characteristics, medical and surgical history, baseline assessment of OAB and FI symptoms and previous treatment for FI, OAB, stress urinary incontinence (SUI) or pelvic organ prolapse (POP). Multivariable logistic regression analyses were performed to determine if any patient factors were associated with a dual diagnosis of FI and OAB.

Results: In total, 398 patients were identified with a primary initial in-office diagnosis of OAB. The mean age was 64, with the majority of patients identifying as white (76%) and postmenopausal (55.6%). Approximately one-third (36.7%) of patients had concurrent prolapse beyond the hymen. When stratified by FI status, demographics did not vary significantly, except for the age of presentation, which was 63 years for the OAB-only group versus 68 years for the OAB/FI group. Notably, only 5% of the OAB-only group and 9% of the OAB/FI group received sacral neuromodulation (SNM) therapy. In a multivariable logistic regression for age, UDI 6 score, prolapse beyond the hymen, PVR, and menopause status, the report of FI on PFDI 20 (question 9) was not significantly associated with any patient factor.

Conclusions: These data demonstrate several important findings; that no patient factors assessed were significantly associated with FI, and that it appears to be independent of either POP or OAB severity. Patients with dual incontinence did not always have SNM and the overall rates of SNM in this cohort were low, indicating a potential area for increased dual diagnosis treatment intervention. This underscores the importance of directly querying patients for a history of fecal incontinence when they present for their initial evaluation.

Table 2 Legend: aOR: adjusted Odds ratio; CI: confidence interval
PFDI: pelvic floor distress inventory-20; UDI-6: urinary distress inventory-6; PVR: post void residual