Sexual function in women with urinary incontinence and pelvic organ prolapse.
OBJECTIVE
To compare sexual function in women with urinary incontinence and pelvic organ prolapse and to determine the effects of therapy on sexual function.


METHODS
343 community-dwelling women older than 45 years with urinary incontinence or advanced prolapse were recruited into a multi-armed clinical trial. Women with incontinence were stratified to receive estrogen therapy, behavioral therapy, or surgical therapy. Women with prolapse were enrolled in a randomized surgical trial. All women completed a standardized urogynecologic evaluation and a sexual function questionnaire at baseline and after therapy.


RESULTS
Women with prolapse or detrusor instability were more likely to cite pelvic floor symptoms as a reason for sexual inactivity than were women with other conditions. One third of patients with prolapse reported that their pelvic floor condition affected their ability to have sexual relations "moderately" or "greatly" significantly more than did other groups. Patients with genuine stress incontinence who underwent surgical or behavioral therapy were less likely to report being worried about urine leakage during intercourse after therapy than at baseline. After surgery, women with prolapse were less likely to report that their symptoms affected their ability to have sexual relations compared with baseline. Overall sexual satisfaction was the same at baseline and remained unchanged in all therapeutic groups at 6 months.


CONCLUSIONS
Prolapse is more likely than urinary incontinence to result in sexual inactivity and to be perceived as affecting sexual relations. However, overall sexual satisfaction appears to be independent of diagnosis of or therapy for urinary incontinence or prolapse.
Barber
Matthew D
MD
Department of Obstetrics and Gynecology, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA. barberm2@ccf.org
Visco
Anthony G
AG
Wyman
Jean F
JF
Fantl
J Andrew
JA
Bump
Richard C
RC
D000368:Aged; D001521:Behavior Therapy; D002986:Clinical Trials as Topic; D004967:Estrogens / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D009657:North Carolina / Q000453:epidemiology; D009820:Ohio / Q000453:epidemiology; D011446:Prospective Studies; D012107:Research Design; D020018:Sexual Dysfunctions, Psychological / Q000453:epidemiology* / Q000209:etiology; D019529:Sexuality / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014549:Urinary Incontinence / Q000150:complications / Q000628:therapy*; D014596:Uterine Prolapse / Q000150:complications / Q000601:surgery*; D014768:Virginia / Q000453:epidemiology
D004967:Estrogens