The association of fecal impaction and urinary retention in elderly nursing home patients

The objective of this study was to examine the association of fecal impaction and urinary retention in an elderly nursing home population. Two-hundred and three nursing home patients with urinary dysfunction (77% female, median age: 85 years (range: 61–104)) underwent an evaluation which included rectal examination, measurement of residual urine, and cystometric studies. Bivariate analyses indicated that fecal impaction was not associated with urinary retention. However, dependency in transfer was directly associated with fecal impaction (OR=2.91; P=0.004), and with urinary retention (OR=3.13; P=0.017). There was no association between detrusor underactivity and fecal impaction. When urinary retention and fecal impaction occurred in the same patient, detrusor overactivity was the most common cystometric finding. Rather than implicating an anatomic or neurologic link between poor bladder emptying and poor bowel emptying, a third factor (e.g. immobility) causing both urinary retention and fecal impaction should be sought.