title: Changes in sexual functioning in women after neuromodulation for voiding dysfunction.
abstract: BACKGROUND
  Sacral neuromodulation is a well-established treatment for urinary and bowel disorders with potential use for other disorders such as sexual dysfunction.
  
  
  OBJECTIVE
  To evaluate changes in sexual functioning in women undergoing neuromodulation for voiding symptoms.
  
  
  METHODS
  Patients enrolled in our prospective, observational neuromodulation database study were evaluated. Data were collected from medical records, and patient-completed Female Sexual Function Index (FSFI) and Interstitial Cystitis Symptom-Problem Indices (ICSI-PI) at baseline, 3, 6, and 12 months post-implant. Patients rated overall change in sexual functioning on scaled global response assessments (GRA) at 3, 6, and 12 months post-implant. We grouped women by baseline FSFI scores: less (score<26) and more sexually functional (score≥26). Data were analyzed with Pearson's Chi-square or Fisher's Exact test and repeated measures.
  
  
  METHODS
  Changes in FSFI and ICSI-PI scores in women grouped by baseline FSFI score<26 and ≥26.
  
  
  RESULTS
  Of 167 women evaluated, FSFI scores improved overall from preimplant (mean 13.5±8.5) to 12 months (N=72; mean 15.9±8.9, P=0.004). At baseline and each follow-up point, ICSI-PI scores were similar between groups and improved through time. For patients in the FSFI<26 group there was improvement from baseline to 12-month scores (N=63; 11.9±6.9 to 14.8±8.7; P=0.0006). Improved FSFI domains included desire, orgasm, satisfaction, and pain. Furthermore, of the 74 subjects in this group not sexually active at baseline, 10 became sexually active during follow-up. In the FSFI≥26 group there was slight but statistically significant decline in mean scores between baseline and 12 months (N=9; 27.4±1.1 to 24.5±3.4; P=0.0302); however one had become sexually inactive. A significant decrease was seen in the satisfaction domain.
  
  
  CONCLUSIONS
  Many factors affect sexual functioning in women; however sexual function may improve along with urinary symptoms after neuromodulation.
authors: Department of Urology, Beaumont Health System, Royal Oak, MI, USA.
authors: Jessica M
authors: JM
authors: Yih
authors: Kim A
authors: KA
authors: Killinger
authors: Judith A
authors: JA
authors: Boura
authors: Kenneth M
authors: KM
authors: Peters
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D004599:Electric Stimulation Therapy / Q000009:adverse effects / Q000295:instrumentation; D005260:Female; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D015999:Multivariate Analysis; D058117:Neural Prostheses; D017060:Patient Satisfaction; D011446:Prospective Studies; D020127:Recovery of Function; D012725:Sexual Behavior; D012735:Sexual Dysfunction, Physiological / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000523:psychology; D020018:Sexual Dysfunctions, Psychological / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000523:psychology; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014555:Urination Disorders / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D055815:Young Adult
keywords: Electrical Stimulation Therapy; Physiological; Sexual Dysfunction; Urination Disorders