Female sexual dysfunction: a new urogynaecological research field.
OBJECTIVE
To critically review published data on the urogynaecological aspects of female sexual dysfunction (FSD), as FSD is a developing multidisciplinary issue associated with several biological, medical and psychological factors.


METHODS
The reported prevalence of FSD is 19-50% and women with lower urinary tract symptoms or urinary incontinence (UI) not only complain of a deteriorating of quality of life but also of sexual life with an incidence as high as 26-47%. Furthermore, urogynaecological surgery represents an important but underestimated cause of FSD. Different databases (Pub Medical, Medline, serial titles, the Cochrane library and the NLM gateway database) were searched for the keywords 'sexuality; sexual function; urinary incontinence; pelvic organ prolapse; questionnaire; symptom severity; epidemiology; quality of life; instruments; sexual health; vagina; vaginal surgery; pelvic surgery'.


RESULTS
There is a lack of a standardized instrument for assessing FSD. Recent studies investigate the impact of UI on sexual function, but the pathophysiology has not been elucidated. Vaginal or pelvic surgery does not affect overall sexual satisfaction.


CONCLUSIONS
Our investigation highlights the need for studies to assess the anatomical, physiological and sensory mechanisms related to FSD. Specific questionnaire are needed to quantify the problem. In the definition, symptoms assessment and preoperative counselling is important, to make a distinction between overall sexual function and individual parameters, such as psychosocial context. Only in this way, will it be possible to identify new therapeutic targets. A definition of success in urogyneacological terms should include aspects of quality of life and quality of sexual life. Immediate research in this field is needed.
Dalpiaz
Orietta
O
Department of Urology, Medical University of Innsbruck, Innsbruck, Austria. orietta.dalpiaz@uki.at
Kerschbaumer
Andrea
A
Mitterberger
Michael
M
Pinggera
Germar M
GM
Colleselli
Daniela
D
Bartsch
Georg
G
Strasser
Hannes
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects; D006801:Humans; D008875:Middle Aged; D015995:Prevalence; D011391:Prolapse; D011788:Quality of Life; D012720:Severity of Illness Index; D012735:Sexual Dysfunction, Physiological / Q000453:epidemiology / Q000209:etiology*; D011795:Surveys and Questionnaires; D014549:Urinary Incontinence / Q000150:complications; D013520:Urologic Surgical Procedures / Q000009:adverse effects; D016387:Women's Health