title: The impact of genital self-image on sexual function in women with pelvic floor disorders.
abstract: OBJECTIVE
  There is conflicting evidence regarding the impact of urinary incontinence and pelvic organ prolapse on overall sexual function. However, psychological variables thought to be associated with sexual function, have not been fully explored. We assessed the sexual functioning of women with pelvic floor disorders while measuring for psychological factors such as distress and genital self-image.
  
  
  METHODS
  In a cross-sectional study, 155 women in an urogynecology outpatient clinic of a tertiary health center completed a demographic questionnaire, the Brief Symptom Index-18 (BSI-18), Pelvic Floor Distress Inventory-20 (PFDI-20), Genital Self-Image Scale-20 (GSIS-20) and the Female Sexual Function Index (FSFI).
  
  
  RESULTS
  Linear regression showed that when controlling for age and depression, GSIS significantly predicted FSFI total score (Beta=0.38, p<0.001) and the Desire subscale (Beta=0.55, p<0.001). Due to the low response rate in the GSIS and FSFI questionnaires, a preliminary analysis was conducted to characterize the responders. On univariate logistic regression, response to the GSIS was negatively correlated with age (OR=0.94, p=0.02) and being in a relationship (OR=2.3, p=0.016), yet the effect of being in a relationship was diminished in a multivariate model that included age.
  
  
  CONCLUSIONS
  The main variable associated with overall sexual function in women with pelvic floor disorders was low genital self-image. This variable is more important than self-reported symptoms, type of specific disorder or other demographic variables. Older women tended not to complete the scales concerning more intimate matters. We suggest that urogynecologists should inquire about genital self-image as well as sexual function in this population.
authors.affiliation: School of Behavioral Sciences, The Academic College of Tel Aviv-Yaffo, Israel. Electronic address: Jonathanh@013.net.
authors.forename: Jonathan E
authors.initials: JE
authors.lastname: Handelzalts
authors.affiliation: School of Behavioral Sciences, The Academic College of Tel Aviv-Yaffo, Israel.
authors.forename: Tal
authors.initials: T
authors.lastname: Yaakobi
authors.affiliation: School of Behavioral Sciences, The Academic College of Tel Aviv-Yaffo, Israel.
authors.forename: Sigal
authors.initials: S
authors.lastname: Levy
authors.affiliation: The Helen Schneider Hospital for Women, Rabin Medical Center, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Yoav
authors.initials: Y
authors.lastname: Peled
authors.affiliation: The Helen Schneider Hospital for Women, Rabin Medical Center, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Arnon
authors.initials: A
authors.lastname: Wiznitzer
authors.affiliation: The Helen Schneider Hospital for Women, Rabin Medical Center, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Haim
authors.initials: H
authors.lastname: Krissi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D059952:Pelvic Floor Disorders / Q000150:complications / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology*; D012649:Self Concept; D012725:Sexual Behavior / Q000523:psychology*; D020018:Sexual Dysfunctions, Psychological / Q000209:etiology / Q000523:psychology*; D011795:Surveys and Questionnaires
keywords: Distress; Genital self-image; Incontinence; Prolapse; Sexual function