Female urinary incontinence during intercourse: a review on an understudied problem for women's sexuality.
BACKGROUND
Coital urinary incontinence is a frequently underreported symptom, with a relevant impact on women's sexuality and quality of life.


OBJECTIVE
This article will review the available evidence on incidence, pathophysiology, and treatment of coital urinary incontinence with the attempt to present the current state of the art.


METHODS
PubMed was searched for reports about coital urinary incontinence that were published from 1970 to 2008, and the most relevant articles were reviewed.


METHODS
Review on epidemiology, pathophysiology, diagnosis, and treatment of coital incontinence.


RESULTS
The incidence of coital incontinence in incontinent women has been reported to range between 10% and 27%. At present, some evidence suggests an association between urinary leakage at penetration and urodynamic stress (USI) incontinence as well as urinary leakage during orgasm and detrusor overactivity (DO). When treatment for these conditions are based upon urodynamic findings, pelvic floor muscle training, surgery, and pharmacotherapy show satisfactory cure rates.


CONCLUSIONS
Coital urinary incontinence deserves much more attention in clinical practice: women should be specifically interviewed for this disturbance because it has a very negative impact on their sexuality. If a reliable urodynamic diagnosis is made, coital urinary incontinence at penetration can be cured in more than 80% of cases by surgery in the presence of USI. The form of coital incontinence during orgasm is curable by antimuscarinic treatment in about 60% of cases when associated with DO.
Serati
Maurizio
M
Department of Obstetrics and Gynecology, Del Ponte Hospital, University of Insubria, Varese, Italy. mauserati@hotmail.com
Salvatore
Stefano
S
Uccella
Stefano
S
Nappi
Rossella E
RE
Bolis
Pierfrancesco
P
D003075:Coitus; D005260:Female; D006801:Humans; D017773:Pelvic Floor / Q000503:physiopathology; D011788:Quality of Life / Q000523:psychology; D012725:Sexual Behavior; D011795:Surveys and Questionnaires; D053201:Urinary Bladder, Overactive / Q000453:epidemiology; D014549:Urinary Incontinence / Q000188:drug therapy / Q000453:epidemiology* / Q000503:physiopathology; D014563:Urodynamics / Q000502:physiology