Sexual function in women with anal incontinence using a new instrument: the PISQ-IR.
BACKGROUND
Anal incontinence (AI) has been associated with sexual complaints. The Pelvic Organ Prolapse/Incontinence Sexual Questionnaire-IUGA Revised (PISQ-IR) has been validated to measure sexual function in sexually active (SA) and non-SA (NSA) women with pelvic floor disorders (PFD) including AI. We describe symptoms in women with PFDs including AI using this instrument.


METHODS
This was a planned secondary analysis of data collected for the validation of the PISQ-IR. SA and NSA women with symptoms of pelvic organ prolapse, urinary incontinence (UI) and/or AI at 12 US and 5 UK sites were recruited. The Female Sexual Function Index (FSFI) and PISQ-IR were completed in addition to the Pelvic Floor Distress Inventory (PFDI), and other measures.


RESULTS
Of 872 women enrolled, 90 (10%) reported AI. Compared with women without AI, women with AI were more likely to report stress UI (p = 0.007), urgency UI (p < 0.001), mixed UI (p < 0.001), diabetes (p = 0.036) and depression (p < 0.001), and to show larger genital hiatus measurements (p = 0.005) and more underactive pelvic floor muscles (p = 0.011). Furthermore, scores on the PFDI showed greater bother (p = 0.013), particularly the colorectal subscale (p < 0.001). While sexual activity was similar between the groups, FSFI desire (p = 0.016), PISQ-IR 'condition-specific' (p = 0.03) and 'global quality' (p = 0.046) domains were worse in women with AI. In logistic regression analysis, only the PISQ-IR 'condition-specific' domain was associated with AI when controlling for other confounders (OR 0.27, 95% CI 0.10 - 0.72, p = 0.009).


CONCLUSIONS
Women with AI have similar rates of sexual activity but poorer sexual function than women without AI. The PISQ-IR may be most appropriate to characterize these conditions.
Division of Female Pelvic Medicine and Reconstructive Surgery, TriHealth Good Samaritan Hospital, 3219 Clifton Ave, Suite 100, Cincinnati, OH, 45220, USA, Rachel_Pauls@trihealth.com.
Rachel N
RN
Pauls
Rebecca G
RG
Rogers
Mitesh
M
Parekh
Joan
J
Pitkin
Dorothy
D
Kammerer-Doak
Peter
P
Sand
D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D003863:Depression / Q000150:complications; D048909:Diabetes Complications / Q000150:complications; D005242:Fecal Incontinence / Q000150:complications / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D059952:Pelvic Floor Disorders / Q000150:complications / Q000503:physiopathology*; D019529:Sexuality; D011795:Surveys and Questionnaires; D014550:Urinary Incontinence, Stress / Q000150:complications; D053202:Urinary Incontinence, Urge / Q000150:complications