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What Is the Real Impact of Urinary Incontinence on Female Sexual Dysfunction? A Case Control Study
Mariana Rhein Felippe1, Joao Paulo Zambon2, Marcia Eli Girotti1
1Department of Urology, University of Sao Paulo, Sao Paulo, Brazil.
Introduction:
Urinary incontinence (UI) has been associated with negative effects on women's sexuality. Women's sexuality and sexual function are a complex issue, and the role of UI is not completely clear.
Aim:
To assess the impact of UI on female sexual function by comparing this population with a control group of continent women.
Methods:
We performed a case-control study from August 2012 to September 2013. We evaluated continent and incontinent women (age range = 30-70 years) for their sexuality.
Main Outcome Measures:
All patients were evaluated by anamnesis, physical examination, and self-report quality-of-life questionnaires. In addition, incontinent women underwent a 1-hour pad test. Patients without sexual activity were evaluated for the role of UI in their sexual abstinence. Sexual abstinence was defined as the absence of sexual activity for more than 6 months. All sexually active women completed the self-report Sexuality Quotient-Female Version (SQ-F) questionnaire.
Results:
A total of 356 women were included in the study (incontinent, n = 243; continent, n = 113). Sexual abstinence was found in 162 women (45%). Incontinent women presented a higher prevalence (P < .001) of sexual abstinence than their counterparts (129 [53%] and 33 [29.2%], respectively). Age, marital status, and UI were found to be isolated predictive factors for more sexual abstinence in incontinent women. Sexually active women (incontinent, n = 114; continent, n = 80) presented similar demographic data. Despite a similar frequency of sexual activity, incontinent women had less sexual desire, foreplay, harmony with a partner, sexual comfort, and sexual satisfaction than their counterparts. Women with greater urinary leakage during the 1-hour pad test (weight > 11 g) had the worst sexual function (SQ-F) score.
Conclusion:
Women with UI were more likely to be sexual abstinent than continent women. Furthermore, women with UI showed less sexual desire, sexual comfort, and sexual satisfaction than their counterparts despite having a similar frequency of sexual activity.
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