Urinary incontinence during sexual intercourse: a common, but rarely volunteered, symptom

A total of 400 women referred consecutively to a gynaecological urology clinic was questioned with regard to their sexual activity and were subsequently investigated by cystometry to establish the prevalence of urinary incontinence occurring during intercourse, and to define the urodynamic background of sufferers. Of the 400 women 324 were sexually active, and of these 79 (24%) experienced incontinence during intercourse; in two thirds of sufferers incontinence occurred on penetration, whereas in the remaining one third urine leakage was restricted to orgasm. Of the former group 70% were shown to have genuine stress incontinence and 4% detrusor instability; of the latter, 42% had genuine stress incontinence and 35% detrusor instability. A comparison of cystometric variables in these two index groups and matched controls failed to identify any specific abnormality of bladder function associated with these symptoms.