Biologic correlates of sexual function in women with stress urinary incontinence

Stress urinary incontinence (SUI) has a great impact on the quality of life and sexual function. We hypothesized that specific risk factors for SUI may be correlated with reduced sexual function in women with SUI.

To explore significant associations between the risk factors for SUI and female sexual function.

Women with SUI (N=223) were surveyed about their sexual function. Demographic data and clinical findings on pelvic examination and the 1-hour pad test were recorded. Sexually active respondents completed the short form of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12).

PISQ-12 and the correlation of the risk factors for SUI with PISQ-12 scores.

Of the 223 subjects, 68 (30%) reported no sexual activity for 6 months or more prior to the interview and did not respond to the PISQ-12. In comparison with the 155 (70%) of women who were sexually active, sexually inactive respondents were older and more likely to be postmenopausal and had a higher parity and more severe prolapse (all P<0.01). Among those completing the PISQ-12 questionnaire, the same factors (age, parity, severity of prolapse, menopausal status) were significantly associated with lower PISQ-12 scores. The scores were not correlated with body mass index, delivery mode, genital hiatus length, and total vaginal length by the short form of the Pelvic Organ Prolapse Quantification (POP-Q) system, or estrogen therapy. Lower points Ba and C of the POP-Q system were associated with lower PISQ-12 scores (r= -0.200, P=0.026; r= -0.191, P=0.035, respectively). Multivariate analysis identified parity as the only factor independently predictive of sexual dysfunction (r= -0.225, P=0.013).

Anatomic and biologic pathology does not satisfactorily predict the level of sexual functioning in women with SUI.