title: Sexual function in obese women: impact of lower urinary tract dysfunction.
abstract: OBJECTIVE
  To assess the impact on sexual function attributed to lower urinary tract dysfunction in a female obese population.
  
  
  METHODS
  We performed a case-control study based on the registry of a university hospital obesity unit. A consecutive sample of women with body mass index(BMI) >or=30 (obese) was randomly matched by age, gender and residential county to control subjects using the computerized Register of the Total Population. Data were collected by a self-reported postal survey including the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12).
  
  
  RESULTS
  The questionnaire was completed and returned by 279/446 patients (62%) and 430/892 control subjects (48%). Obese women reported significantly lesser satisfaction with their sexual life, more frequent symptoms of urinary incontinence at intercourse, more often fear of urine leakage at intercourse, a higher tendency toward avoiding intercourse and more frequent feelings of guilt and disgust during intercourse (P<0.001). While considering sexual function in a subset of women with urge or stress urinary incontinence, the overall PISQ-12 scores were significantly lower in obese women compared to their age-matched nonobese controls for both the conditions (P<0.001). In an adjusted multivariate analysis, a BMI >30 was independently associated with a significantly increased risk for sexual dysfunction (odds ratio (OR) 1.8; 95% confidence interval (CI) 1.1-2.9), as were symptoms of urge or stress urinary incontinence (OR, 2.0; 95% CI, 1.3-3.1 and OR, 2.6; 95% CI, 1.7-4.0), respectively.
  
  
  CONCLUSIONS
  Urge and stress urinary incontinences are more common and have greater impact on sexual function in obese women.
authors.affiliation: Department of Medicine, Obesity Unit, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: I
authors.initials: I
authors.lastname: Melin
authors.forename: C
authors.initials: C
authors.lastname: Falconer
authors.forename: S
authors.initials: S
authors.lastname: Rössner
authors.forename: D
authors.initials: D
authors.lastname: Altman
mesh_terms: D000328:Adult; D000886:Anthropometry; D015992:Body Mass Index; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008019:Life Style; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D011788:Quality of Life; D012307:Risk Factors; D012735:Sexual Dysfunction, Physiological / Q000209:etiology*; D020018:Sexual Dysfunctions, Psychological / Q000209:etiology*; D012959:Socioeconomic Factors; D014549:Urinary Incontinence / Q000209:etiology*; D014550:Urinary Incontinence, Stress / Q000209:etiology; D055105:Waist Circumference