Sexual dysfunction is common in women with lower urinary tract symptoms and urinary incontinence: results of a cross-sectional study.
OBJECTIVE
The aim of this study was to determine the prevalence of sexual dysfunctions in women with urinary incontinence and/or lower urinary tract symptoms as compared to a general female population.


METHODS
We extensively evaluated 227 consecutive women (mean age 52; age range 19-66) complaining of urinary incontinence (UI) and/or lower urinary tract symptoms (LUTS) with a comprehensive history (including several validated questionnaires), a complete physical examination and a urodynamic multichannel evaluation. Two hundred and sixteen patients were eligible for sexual function investigation because 11 out of 227 (5%) were not interested in dealing with questions regarding their own sexuality and were thus excluded from the final evaluation results. A group of 102 age-matched women (mean age 54; age range 19-63) assessed for a yearly routine gynaecological evaluation and not complaining of urinary symptoms were enrolled as cross-sectional controls and investigated in accordance with the Female Sexual Function Index (FSFI).


RESULTS
Sexual dysfunction was diagnosed in 99 out of 216 patients (46%). Of these, 34 (34%) reported hypoactive sexual desire, 23 (23%) reported sexual arousal disorder; 11 patients (11%) complained of orgasmic deficiency, and 44 (44%) suffered from sexual pain disorder (e.g., dyspareunia or non-coital genital pain). Women reporting low sexual desire commonly suffered from stress incontinence (47%). We found that 60% of the women with sexual arousal disorders and 61% of those with sexual pain disorders also complained of recurrent bacterial cystitis. Forty-six percent of those complaining of orgasmic phase difficulties also reported a troublesome urge incontinence. The FSFI values in both groups scored as follows (patients versus controls; median value; p value): desire: 2.0 vs. 3.2 (p<0.01); arousal: 2.8 vs. 3.6 (p=n.s.); lubrication: 3.2 vs. 4.4 (p=0.01); orgasm: 4.1 vs. 4.4 (p=n.s.); sexual satisfaction: 2.7 vs. 4.0 (p<0.01); sexual pain: 1.8 vs. 4.0 (p<0.001).


CONCLUSIONS
Women reporting UI or LUTS also complained of sexual dysfunctions in a significantly higher number than a general, healthy female population not complaining of urinary symptoms. Investigation of female sexuality is suggested for these patients.
Salonia
Andrea
A
Divisione di Urologia, University Vita-Salute San Raffaele, Istituto Scientifico San Raffaele, Via Olgettina 60, 20132 Milano, Italy.
Zanni
Giuseppe
G
Nappi
Rossella E
RE
Briganti
Alberto
A
Dehò
Federico
F
Fabbri
Fabio
F
Colombo
Renzo
R
Guazzoni
Giorgio
G
Di Girolamo
Valerio
V
Rigatti
Patrizio
P
Montorsi
Francesco
F
D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D012735:Sexual Dysfunction, Physiological / Q000453:epidemiology / Q000209:etiology*; D014522:Urethral Diseases / Q000150:complications*; D001745:Urinary Bladder Diseases / Q000150:complications*; D014549:Urinary Incontinence / Q000150:complications*