Prevalence and risk factors of fecal incontinence in community-dwelling men

Fecal incontinence (FI) in community-dwelling men affects quality of life and increases the risk of institutionalization. Observational studies and randomized, controlled trials (RCTs) on epidemiology and prevention of FI published in English from 1990 to November 2007 were identified in several databases to abstract rates and adjusted odds ratios (ORs) of incontinence and to synthesize evidence with random effects models. Twenty-one observational studies and 4 RCTs were eligible for analysis. Pooled prevalence of FI in elderly men increased with age to 5% to 6%. Men over age 85 years (OR 2.5; 95% confidence interval [CI], 1.3-5) and with kidney diseases (OR 1.9; 95% CI, 1.2-3.3) had higher odds of incident FI. Significantly impaired cognitive status and general health were associated with FI. Men had increased risk of incontinence after radical prostatectomy or radiation for prostate cancer. Lower doses of radiation caused inconsistent reduction in FI across 2 RCTs. The prevalence of incontinence increased with age and functional dependency. Cognitive impairment, poor general health, surgery, and radiation for prostate cancer were associated with incontinence in community-dwelling men. No effective interventions are known at the present time.