title: Sexual function before and after non-surgical treatment for stress urinary incontinence.
abstract: OBJECTIVES: (1) to describe sexual function in women seeking treatment of stress urinary incontinence (SUI); (2) to compare the impact on sexual function of three SUI treatments; and (3) to investigate whether non-surgical treatment of SUI is associated with improved sexual function.  METHODS: Women with SUI were randomized to continence pessary, behavioral therapy (pelvic floor muscle training and continence strategies), or combination therapy. Sexual function was assessed at baseline and 3-months using short forms of the Pelvic Organ Prolapse-Urinary Incontinence Sexual Function Questionnaire (PISQ-12) and the Personal Experiences Questionnaire (SPEQ). Successful treatment of SUI was assessed with a patient global impression of improvement. ANOVA was used to compare scores between groups.  RESULTS: At baseline, sexual function was worse among women with mixed incontinence compared to those with pure SUI. After therapy, successful treatment of SUI was associated with greater improvement in PISQ-12 score (2.26 ± 3.24 versus 0.48 ± 3.76, p=0.0007), greater improvement in incontinence with sexual activity (0.45 ± 0.84 versus 0.01 ± 0.71, p=0.0002), and greater reduction in restriction in sexual activity related to fear of incontinence (0.32 ± 0.76 versus -0.06 ± 0.78, p=0.0008). Among those successfully treated for SUI, improvement in continence during sexual activity was greater in both the combined therapy group (p=0.019) and the behavioral group (p=0.02) compared to the pessary group.  CONCLUSIONS: Successful non-surgical treatment of SUI is associated with improvements in incontinence-specific measures of sexual function. Behavioral therapy may be preferred to pessary for treatment of SUI among women whose incontinence interferes with sexual function.
authors.affiliation: Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore, MD.
authors.forename: Victoria L
authors.initials: VL
authors.lastname: Handa
authors.forename: Emily
authors.initials: E
authors.lastname: Whitcomb
authors.forename: Alison C
authors.initials: AC
authors.lastname: Weidner
authors.forename: Ingrid
authors.initials: I
authors.lastname: Nygaard
authors.forename: Linda
authors.initials: L
authors.lastname: Brubaker
authors.forename: Catherine S
authors.initials: CS
authors.lastname: Bradley
authors.forename: Marie Fidela R
authors.initials: MF
authors.lastname: Paraiso
authors.forename: Joseph
authors.initials: J
authors.lastname: Schaffer
authors.forename: Halina M
authors.initials: HM
authors.lastname: Zyczynski
authors.forename: Min
authors.initials: M
authors.lastname: Zhang
authors.forename: Holly E
authors.initials: HE
authors.lastname: Richter