ORIGINAL ARTICLE Lower urinary tract symptoms in chronically constipated women Dan Carter & Marc Beer-Gabel Received: 22 February 2012 / Accepted: 22 April 2012 / Published online: 16 May 2012 # The International Urogynecological Association 2012 Abstract Introduction and hypothesis The prevalence of lower urinary tract symptoms (LUTS) is as high as 66 % in the general population. Constipation rates of >30 % were reported among women with LUTS. We examined the association of chronic constipation to the occurrence of LUTS and, in particular, the relationship of LUTS to the type of constipation. We also examined the prevalence and association of pelvic organ prolapse (POP) to LUTS. Methods In a retrospective survey of data collected on patients referred to our clinic during 2008–2009 for assess- ment of chronic constipation, 161 constipated women and 162 healthy female volunteers completed a structured question- naire of urinary and bowel habits components (BBUS-Q22), the constipation scoring system for assessment of constipation severity and the Rome III component for IBS and chronic constipation. The constipated group underwent dynamic transperineal ultrasound. Results Demographic data was similar in both groups. LUTS were more common in the constipated group (in- creased urinary frequency 34 % vs. 14 %, p < 0.001, nocturia 31 % vs. 8 %, p <0.001, urinary urgency 53 % vs. 21 %, p < 0.001, incomplete urinary emptying 24 % vs. 9 %, p 0 0.003 and urinary incontinence 21 % vs. 5 %, p <0.0001). Urinary symptoms did not vary between IBS and functional consti- pation. In addition, the occurrence of urinary symptoms was unrelated to the diagnosis of posterior pelvic organ prolapse (POP) in the constipated group. Conclusions LUTS are common in constipated women, but are unrelated to the type of constipation. These findings may suggest that the constipation process may have a direct con- tribution to the occurrence of LUTS. Keywords Constipation . LUTS . POP . IBS Introduction Chronic constipation is a common condition, reported by two thirds of middle aged women at least once a year, and in 12 % at least once a week [1–4]. Chronic constipation can be classified into functional and irritable bowel syndrome (IBS) related. [5]. Lower urinary tract symptoms (LUTS) are wide- spread conditions affecting 16 %-53 % of adult women [6–8]. LUTS can be divided into three categories: storage, voiding, and postmicturition [9]. Storage symptoms are believed to be correlated with underlying detrusor overactivity [10] and in- clude increased micturition frequency, nocturia, urinary ur- gency, and urinary incontinence (UI) [11]. Voiding symptoms are correlated to impaired detrusor contractility and include slow or weak stream, hesitancy, and terminal dribble. Post- micturition symptoms include the sensation of incomplete emptying and postmicturition dribble [11]. Few uncontrolled retrospective cohort studies described high rates of anorectal dysfunction among middle aged women with LUTS, and constipation was reported in >30 % in this group. [12, 13]. The aim of our study was to examine the correlation be- tween the occurrence of urinary symptoms and chronic consti- pation and to define possible causes for this correlation. Methods Patients and controls The present study is a retrospective survey of data that has been collected on patients referred to our clinic between 2008–2009 for assessment and evaluation of chronic constipation. As part of their evaluation, all patients were questioned for constipation, D. Carter (*) : M. Beer-Gabel Pelvic Floor Service, Department of Gastroenterology, Sheba Medical Center, Ramat Gan, Israel e-mail: carterd@zahav.net.il Int Urogynecol J (2012) 23:1785–1789 DOI 10.1007/s00192-012-1812-1