Prevalence of and risk factors for anal incontinence: a large-scale multicentre study in Turkey

PURPOSE: Anal incontinence (AI), characterized by involuntary leakage of gas or stool, adversely affects quality of life and is associated with various comorbidities. Limited data exist regarding its prevalence in Turkey. METHOD: To assess the prevalence and implications of AI, a multicentre study encompassing seven regions of Turkey was conducted. A power analysis was conducted before the study, and it was calculated that at least 7927 individuals were required to be screened to achieve a minimum AI prevalence of 2.5%. A survey of 8844 relatively healthy persons visiting outpatient clinics was conducted by health care professionals in a face-to-face manner across seven geographical regions in Turkey. The survey utilized the Wexner incontinence scale score and collected information on surgical history, chronic diseases, gynaecological conditions, and regional variations. RESULTS: The prevalence of anal incontinence in Turkey was 2.3% (95% CI, 2-2.5%). The prevalence of AI increased with increasing age (65+ y/o), prolapse (p < 0.0001), and AI was also found to be associated with chronic conditions, including chronic medication usage and bowel habits (diarrhoea/constipation) (p < 0001). Vaginal delivery and prostate surgery were also associated with AI (p < 0001). Significant associations were observed between AI rates in women and certain gynaecological conditions. Additionally, regional differences in AI prevalence were also identified. CONCLUSION: The results of the present study revealed that AI is more prevalent among older individuals and women and is associated with chronic illness, bowel habits, vaginal delivery, and chronic medications. Additionally, particular attention should be given to the role of gynaecological conditions in AI in women.