title: Is Pelvic Floor Dysfunction an Independent Threat to Sexual Function? A Cross-Sectional Study in Women With Pelvic Floor Dysfunction.
abstract: Prior studies have reported an association of sexual dysfunction with pelvic floor dysfunction (PFD), but without defining causation.
  
  
  
  To investigate predictors of sexual function in women with PFD, including pelvic organ prolapse, stress urinary incontinence, overactive bladder, obstructed defecation, and fecal incontinence.
  
  
  
  This retrospective cross-sectional study included 755 women (mean age = 56 years, 68% postmenopausal) referred for PFD (2008-2013). Subjects underwent standardized history and examination, including demographics and assessment of pelvic floor function and sexual function using validated quality-of-life instruments. The physical examination included body mass index, Pelvic Organ Prolapse Quantification measurements, and pelvic muscle strength (Oxford scale). Proportional odds regression analysis tested patient characteristics, PFD, and other determinants of sexual dysfunction as predictors of sexual function.
  
  
  
  The Pelvic Floor Distress Inventory (PFDI-20) and Pelvic Floor Impact Questionnaire (PFIQ-7) to assess PFD and the Short Personal Experiences Questionnaire to assess sexual function.
  
  
  
  The prevalence of PFD included pelvic organ prolapse (72%), stress urinary incontinence (66%), overactive bladder (78%), fecal incontinence (41%), and obstructed defecation (70%). Most subjects (74%) had a sexual partner and most (56%) reported recent sexual intercourse. Participants reported a low level of sexual desire and sexual enjoyment and moderate levels of sexual arousal and orgasm. When stratified by sexual enjoyment, 46% enjoyed sex and this group had lower PFDI and PFIQ scores, reflecting less quality-of-life burden. Pelvic organ prolapse, obstructed defecation, and fecal incontinence were associated with not enjoying sex. However, when adjusted for other determinants of sexual dysfunction (eg, aging, dyspareunia, atrophy, and partner issues), these associations disappeared.
  
  
  
  Women with PFD also have a large burden of sexual dysfunction, although this appears to be mediated by factors not unique to PFD.
authors.affiliation: Department of Obstetrics and Gynecology, University of Western Ontario, London, ON, Canada.
authors.forename: Ryan J
authors.initials: RJ
authors.lastname: Li-Yun-Fong
authors.affiliation: Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, BC, Canada.
authors.forename: Maryse
authors.initials: M
authors.lastname: Larouche
authors.affiliation: Department of Obstetrics and Gynecology, University of Alberta, Edmonton, AB, Canada.
authors.forename: Momoe
authors.initials: M
authors.lastname: Hyakutake
authors.affiliation: Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, BC, Canada.
authors.forename: Nicole
authors.initials: N
authors.lastname: Koenig
authors.affiliation: Department of Medicine, University of British Columbia, Vancouver, BC, Canada.
authors.forename: Catherine
authors.initials: C
authors.lastname: Lovatt
authors.affiliation: Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, BC, Canada.
authors.forename: Roxana
authors.initials: R
authors.lastname: Geoffrion
authors.affiliation: Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, BC, Canada.
authors.forename: Lori A
authors.initials: LA
authors.lastname: Brotto
authors.affiliation: Centre for Health Evaluation & Outcome Sciences, University of British Columbia, Vancouver, BC, Canada.
authors.forename: Terry
authors.initials: T
authors.lastname: Lee
authors.affiliation: Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, BC, Canada; Centre for Health Evaluation & Outcome Sciences, University of British Columbia, Vancouver, BC, Canada. Electronic address: geoff.cundiff@ubc.ca.
authors.forename: Geoffrey W
authors.initials: GW
authors.lastname: Cundiff
mesh_terms: D000328:Adult; D000368:Aged; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D017773:Pelvic Floor / Q000503:physiopathology*; D059952:Pelvic Floor Disorders / Q000453:epidemiology* / Q000503:physiopathology; D015995:Prevalence; D012189:Retrospective Studies; D012735:Sexual Dysfunction, Physiological / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D053201:Urinary Bladder, Overactive / Q000453:epidemiology; D014549:Urinary Incontinence / Q000453:epidemiology*; D016387:Women's Health
keywords: Female Sexual Dysfunction; Incontinence; Menopause; Pelvic Floor Dysfunction; Pelvic Organ Prolapse; Sexual Desire