Prevalence and Treatment of Anal Incontinence in Primiparous Women

This study has been completed.
St. Olavs Hospital
Norwegian University of Science and Technology
Information provided by (Responsible Party):
Ostfold Hospital Trust Identifier:
First received: September 1, 2009
Last updated: October 15, 2014
Last verified: October 2014

Traumatic tears of the sphincter ani muscles after delivery may result in symptomatic urinary and anal incontinence, particularly in primiparas. A prolonged 2nd stage of delivery is the most common complication during labour and appears to be an important risk factor for traumatic tears of the pelvic floor muscles (PFM) and subsequent problems with incontinence.

The efficacy of pelvic floor muscle exercise (PFME) in treating urinary incontinence is well documented, however, to date there is little evidence to support the efficacy of PFME in treating symptomatic anal incontinence.

This project consists of three separate studies. The prevalence survey/ study (1), investigates the prevalence of symptomatic anal incontinence among primiparas at Ostfold Hospital Trust Fredrikstad, Norway and St Olav's Hospital, Trondheim University Hospital, Norway, and the results in this study will form the basis of the two randomized controlled trials (RCT) investigating the treatment efficacy of PFME. Women with a prolonged 2nd stage of delivery and symptomatic anal incontinence (2) and women who have sustained a traumatic 3rd or 4th degree tear of the sphincter ani muscles during delivery (3), respectively, are randomized to an intervention group receiving PFME treatment for six months, or a control group. All RCT participants will undergo examination of PFM strength and activity, as well as anal ultrasound prior to randomization and after the intervention period.

Condition Intervention
Fecal Incontinence
Other: Pelvic floor muscle training
Other: Control group

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: Prevalence and Treatment of Anal Incontinence in Primiparous Women

Resource links provided by NLM:

Further study details as provided by Ostfold Hospital Trust:

Primary Outcome Measures:
  • Anal incontinence as measured on the St. Mark's score [ Time Frame: 0, 6 and 12 months post partum ] [ Designated as safety issue: No ]
    Survey using the questionnaires St. Mark's score for measuring anal incontinence, ICI-Q SF score measuring urinary incontinence and the Fecal Incontinence Quality of Life score.

Secondary Outcome Measures:
  • Urinary incontinence [ Time Frame: 2009-2011 ] [ Designated as safety issue: No ]
    International Consultation of Incontinence Questionnaire, short form (ICI-Q SF)

  • Quality of Life [ Time Frame: 2009-2011 ] [ Designated as safety issue: No ]
    Fecal Incontinence of Life (FIQL) scale

Enrollment: 1571
Study Start Date: May 2009
Study Completion Date: April 2014
Primary Completion Date: April 2014 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Control group
Females with symptomatic anal insufficiency undergo clinical examination but are not offered intervention the first 6 months. After 6 months they are offered the same intervention as the intervention group, i.e. PFMT for 6 months.
Other: Control group
Clinical examination, no intervention for the first 6 months. Then PFMT treatment for the nest 6 months
Other Name: No intervention for 6 months. Then PFMT for 6 months
Active Comparator: Intervention group
Females with symptomatic anal incontinence randomized to the intervention group for the first 6 months receive Pelvic floor muscle training (PFMT) for 6 months before new clinical tests are carried out. They follow the same PFMT for another 6 months, before the third and final clinical tests are performed.
Other: Pelvic floor muscle training
6 months of daily pelvic floor exercise treatment with regular follow up by specialist physiotherapist. After clinical tests this intervention is continued for another 6 months.
Other Names:
  • pelvic floor muscle strengthening exercises
  • biofeedback/ electrical stimulation


Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Female
Accepts Healthy Volunteers:   Yes

Inclusion Criteria:

  • Primiparas

Exclusion Criteria:

  • Diabetes mellitus
  • Irritable bowel syndrome
  • Neurological diseases such as Multiple Sclerosis
  • Previous abdominal/colon surgery
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its identifier: NCT00970320

Ostfold Hospital Trust
Fredrikstad, Ostfold, Norway, 1603
Sponsors and Collaborators
Ostfold Hospital Trust
St. Olavs Hospital
Norwegian University of Science and Technology
Principal Investigator: Arvid Stordahl, MD PhD Ostfold Hospital Trust
  More Information

No publications provided

Responsible Party: Ostfold Hospital Trust Identifier: NCT00970320     History of Changes
Other Study ID Numbers: 3170 
Study First Received: September 1, 2009
Last Updated: October 15, 2014
Health Authority: Norway: Regional Ethics Commitee
Norway: Norwegian Social Science Data Services

Keywords provided by Ostfold Hospital Trust:
Anal Incontinence
urinary incontinence
pelvic floor exercise treatment
Quality of Life (QoL)

Additional relevant MeSH terms:
Fecal Incontinence
Digestive System Diseases
Gastrointestinal Diseases
Intestinal Diseases
Rectal Diseases processed this record on February 09, 2016