Anterior colpocele protects against constipation; posterior colpocele increases risk

In older women with urinary symptoms or genital prolapse, a clear relationship exists between constipation and posterior aspects of pelvic floor support.

Marco Soligo, MD, of the University of Milan-Bicocca-Bassini Hospital in Italy, and colleagues reviewed the records of 786 women with an average age of 60 years who had urinary symptoms or genital prolapse (44% had genital prolapse greater or equal to 2 degrees, according to the Half Way System). The women underwent a urogynecologic exam and were asked about bowel habits.

Thirty-two percent of the women experienced constipation, and those women were more likely to have a posterior colpocele than nonconstipated women (35% vs. 19%). Overall, the risk of constipation was 2.31 times higher in women with a posterior colpocele than other women. By contrast, an anterior colpocele appeared to protect against constipation (OR 0.80). There was no association between genital prolapse and constipation.

Soligo M, Salvatore S, Emmanuel AV, et al. Patterns of constipation in urogynecology: clinical importance and pathophysiologic insights. Am J Obstet Gynecol. 2006;195:50-55.