title: What Is the Real Impact of Urinary Incontinence on Female Sexual Dysfunction? A Case Control Study.
abstract: BACKGROUND
  Urinary incontinence (UI) has been associated with negative effects on women's sexuality. Women's sexuality and sexual function are a complex issue, and the role of UI is not completely clear.
  
  
  OBJECTIVE
  To assess the impact of UI on female sexual function by comparing this population with a control group of continent women.
  
  
  METHODS
  We performed a case-control study from August 2012 to September 2013. We evaluated continent and incontinent women (age range = 30-70 years) for their sexuality.
  
  
  METHODS
  All patients were evaluated by anamnesis, physical examination, and self-report quality-of-life questionnaires. In addition, incontinent women underwent a 1-hour pad test. Patients without sexual activity were evaluated for the role of UI in their sexual abstinence. Sexual abstinence was defined as the absence of sexual activity for more than 6 months. All sexually active women completed the self-report Sexuality Quotient-Female Version (SQ-F) questionnaire.
  
  
  RESULTS
  A total of 356 women were included in the study (incontinent, n = 243; continent, n = 113). Sexual abstinence was found in 162 women (45%). Incontinent women presented a higher prevalence (P < .001) of sexual abstinence than their counterparts (129 [53%] and 33 [29.2%], respectively). Age, marital status, and UI were found to be isolated predictive factors for more sexual abstinence in incontinent women. Sexually active women (incontinent, n = 114; continent, n = 80) presented similar demographic data. Despite a similar frequency of sexual activity, incontinent women had less sexual desire, foreplay, harmony with a partner, sexual comfort, and sexual satisfaction than their counterparts. Women with greater urinary leakage during the 1-hour pad test (weight > 11 g) had the worst sexual function (SQ-F) score.
  
  
  CONCLUSIONS
  Women with UI were more likely to be sexual abstinent than continent women. Furthermore, women with UI showed less sexual desire, sexual comfort, and sexual satisfaction than their counterparts despite having a similar frequency of sexual activity.
authors.affiliation: Department of Urology, University of Sao Paulo, Sao Paulo, Brazil. Electronic address: ma.rheinfelippe@gmail.com.
authors.forename: Mariana Rhein
authors.initials: MR
authors.lastname: Felippe
authors.affiliation: Institute of Regenerative Medicine, Wake Forest University, Winston-Salem, North Carolina.
authors.forename: Joao Paulo
authors.initials: JP
authors.lastname: Zambon
authors.affiliation: Department of Urology, University of Sao Paulo, Sao Paulo, Brazil.
authors.forename: Marcia Eli
authors.initials: ME
authors.lastname: Girotti
authors.affiliation: Department of Urology, University of Sao Paulo, Sao Paulo, Brazil.
authors.forename: Juliana Schulze
authors.initials: JS
authors.lastname: Burti
authors.affiliation: Department of Urology, University of Sao Paulo, Sao Paulo, Brazil.
authors.forename: Claudia Rosenblatt
authors.initials: CR
authors.lastname: Hacad
authors.affiliation: Department of Urology, University of Sao Paulo, Sao Paulo, Brazil.
authors.forename: Lina
authors.initials: L
authors.lastname: Cadamuro
authors.affiliation: Institute of Regenerative Medicine, Wake Forest University, Winston-Salem, North Carolina.
authors.forename: Fernando
authors.initials: F
authors.lastname: Almeida
keywords: Female Sexual Function; Sexuality; Urinary Incontinence