Sexual function and quality of life in women with urinary incontinence treated by a complete pelvic floor rehabilitation program (biofeedback, functional electrical stimulation, pelvic floor muscles exercises, and vaginal cones).
BACKGROUND
Urinary incontinence (UI) is a debilitating condition that can cause discomfort, embarrassment, loss of confidence; it can lead to withdrawal from social life, and adversely affects physical and mental health, sexual function and quality of life (QoL) in women.


OBJECTIVE
The aim is to determine the impact of combined pelvic floor rehabilitation (PFR) on UI, female sexual dysfunction, and QoL.


METHODS
Female Sexual Function Index questionnaire (FSFI) and King's Health Questionnaire (KHQ).


METHODS
Sixteen patients with UI were selected and underwent a complete PFR program (biofeedback, functional electrical stimulation, pelvic floor muscles exercises, and vaginal cones). Patient filled out the FSFI questionnaire and the KHQ at the baseline and at follow-up.


RESULTS
After PFR none of the patients reported urine leakage during sexual activity. Resolution of incontinence was achieved in 13 (81.25%) women. Only three (18.75%) patients had positive 1-hour pad test after the treatment. There was significant difference between pad test leakage before and after the PFR (P < 0.001). The mean Stamey incontinence score was 1.37 +/- 0.5 at the baseline vs. 0.25 +/- 0.57 at the follow up (P < 0.001). Before PFR, FSFI total score ranged from 25.8 to 2 (mean 14.65 +/- 6.88), after treatment the FSFI total score ranged from 36 to 2 (mean 22.65 +/- 9.5) (P < 0.001). The improvement of the scores in the six FSFI domains, 5 months after the conclusion of PFR, was statistically significant (desire, arousal, lubrication, orgasm, satisfaction, and pain). All the nine domains in the KHQ presented a low average score after treatment and the improvements were statistically significant.


CONCLUSIONS
PFR led to a significant difference in the daily use of pads, 1-hour pad test, and Stamey incontinence scores. The treatment caused an improvement in patient's QoL index and sexual function.
Urology Department, University of Modena and Reggio Emilia, Modena, Italy. ri.max@hotmail.it
Massimo
M
Rivalta
Maria Chiara
MC
Sighinolfi
Salvatore
S
Micali
Stefano
S
De Stefani
Giampaolo
G
Bianchi
D000328:Adult; D000368:Aged; D001676:Biofeedback, Psychology; D004558:Electric Stimulation / Q000295:instrumentation*; D015444:Exercise; D005260:Female; D006801:Humans; D008875:Middle Aged; D009130:Muscle, Smooth / Q000294:innervation; D017773:Pelvic Floor / Q000294:innervation*; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*; D011795:Surveys and Questionnaires; D014549:Urinary Incontinence / Q000523:psychology* / Q000534:rehabilitation*; D014621:Vagina / Q000294:innervation*