title: Improved sexual and urinary function in women with sacral nerve stimulation.
abstract: OBJECTIVE
  Urinary and sexual function improve following sacral nerve stimulation (SNS) for refractory overactive bladder. No significant associations between these changes have been found. Whether improvements in sexual function are independent of or secondary to improvements in urinary function remains unclear. The aim of this study was to analyze changes in urinary and sexual function in a homogeneous sample of patients undergoing SNS for urge urinary incontinence and subsequently identify associations between the two.
  
  
  METHODS
  A prospective database was created. Enrollees underwent a full history and physical examination at the first office visit. Multiple-day voiding diaries with validated and investigator-designed questionnaires were administered at baseline and follow-up as standard implantation procedures and to assess changes in urinary and sexual function, respectively. Analyses were completed using data from patients who were sexually active at baseline and follow-up.
  
  
  RESULTS
  Statistically significant improvements in urinary and sexual function occurred according to multiple metrics. Patient global impression scales categorized all patients' urinary conditions as improved, with most being less severe. Validated urinary symptom and quality of life scores improved significantly. After treatment, most patients were incontinent less often with sexual activity and felt less restricted from sexual activity by fear of incontinence. Validated quantification of sexual function demonstrated significant improvements in overall sexual function, arousal, and satisfaction. No significant associations between changes in urinary and sexual function were noted; however, trends appeared to exist between the two.
  
  
  CONCLUSIONS
  Improved sexual function was not significantly associated with improved urinary function after SNS despite apparent trends between the two. Larger samples are required to definitively demonstrate this conclusion.
authors.affiliation: Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, Ohio, USA.
authors.forename: Bradley C
authors.initials: BC
authors.lastname: Gill
authors.forename: Mia A
authors.initials: MA
authors.lastname: Swartz
authors.forename: Farzeen
authors.initials: F
authors.lastname: Firoozi
authors.forename: Raymond R
authors.initials: RR
authors.lastname: Rackley
authors.forename: Courtenay K
authors.initials: CK
authors.lastname: Moore
authors.forename: Howard B
authors.initials: HB
authors.lastname: Goldman
authors.forename: Sandip P
authors.initials: SP
authors.lastname: Vasavada
mesh_terms: D000368:Aged; D004599:Electric Stimulation Therapy / Q000295:instrumentation / Q000379:methods*; D004567:Electrodes, Implanted; D005260:Female; D006801:Humans; D008875:Middle Aged; D010525:Peripheral Nerves / Q000502:physiology*; D011446:Prospective Studies; D011788:Quality of Life; D012725:Sexual Behavior / Q000502:physiology*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000294:innervation*; D053201:Urinary Bladder, Overactive / Q000601:surgery*; D014554:Urination / Q000502:physiology