Sexual function in women with uterovaginal prolapse and urinary incontinence

To compare sexual function in women with and without uterovaginal prolapse and urinary incontinence.

Eighty women with prolapse and with or without incontinence and 30 continent women without prolapse completed questionnaires assessing sexual function and underwent a physical examination.

Women with prolapse were older than those without prolapse (mean age +/- standard deviation 58.2 +/- 13.0 versus 49.2 +/- 8.4 years, respectively; P < .001). The proportions of sexually active women were similar in both groups (56 and 57% for those with and those without prolapse, respectively). Measures of sexual function were not significantly different between the two groups. The mean global sexual function score was 0.58 +/- 0.15 in the prolapse group and 0.55 +/- 0.14 in the comparison group, a nonsignificant difference. The proportion of women with vaginal dryness or dyspareunia did not differ significantly between the two groups. Interest in sexual activity was unchanged in 70% of sexually active women with prolapse and incontinence, and 84% reported satisfaction with their sexual relationship. Twenty of 45 (44%) sexually active women with prolapse reported incontinence during sexual activity, and 14 (31%) reported that incontinence or prolapse interfered with sexual activity. After multivariate analysis, increasing age was the only significant factor predictive of a higher global sexual function score (P = .02), indicating worse sexual function. Increasing grade of prolapse predicted interference with sexual activity (P = .05), although this did not affect frequency of intercourse or description of satisfaction with the sexual relationship.

Women with prolapse and urinary incontinence do not differ from continent women without prolapse in measures of sexual function; age is the most important predictor of sexual function.