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Sexual functions and quality of life of women over 50 years with urinary incontinence, lower urinary tract symptoms and/or pelvic organ prolapse

Abstract

Sexual function is important for health and quality of life. We evaluated effects of lower urinary tract symptoms (LUTS), urinary incontinence (UI) and coital incontinence, and/or pelvic organ prolapse (POP) on sexual functions and quality of life of women over 50 years of age. Secondary objectives were to compare rate of sexual activity, effects of type of UI and coital incontinence on sexual functions and quality of life among age groups. Female-Sexual-Function-Index (FSFI), Pelvic-Organ-Prolapse/Urinary-Incontinence Sexual-Function-Questionnaire-12 (PISQ-12), and King’s-Health-Questionnaire (KHQ) were used for evaluation. Between 2013 and 2018, 1256 women were included. 565 women were 50–59 years (Group 1), 440 were 60–69 (Group 2), 251 were over 70 (Group-3). 763 women (60.7%) suffered from LUTS, 141 women (11.2%) suffered from POP only, and 352 women (28%) suffered from POP + LUTS. Younger women were more sexually active (p = 0.001). FSFI and PISQ-12 scores of women suffering from LUTS, POP + LUTS, and POP only were similar. Lubrication and orgasm scores were worse in Group 3 (p = 0.006 and 0.037). Type of UI did not affect FSFI and PISQ-12 scores. Coital incontinence was correlated with mixed UI in Groups 1 (p = 0.01) and 2 (p = 0.03). There was no association with coital incontinence and type of UI in Group 3. Coital incontinence had adverse effect in FSFI, PISQ-12 scores. In younger women, coital incontinence had an adverse effect on desire and arousal domains. KHQ scores were worse in women having LUTS in comparison to women suffering from POP only (p = 0.00) and were worse in Groups 1 and 2 (p = 0.002 and 0.013). KHQ scores were worse in women suffering from urge or mixed UI (p = 0.00). Coital incontinence had adverse effect in KHQ scores. In conclusion, aging, LUTS, UI, and coital incontinence have detrimental effects on sexual functions and quality of life. Urge or mixed UI have more adverse effects on quality of life. Quality of life is worse in younger women suffering from UI and coital incontinence.

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References

  1. Bump RC, Norton PA. Epidemiology and natural history of pelvic floor dysfunction. Obstet Gynecol Clin North Am. 1998;25:723–46.

    CAS  PubMed  Google Scholar 

  2. Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, et al. The standardisation of terminology in lower urinary tract function: report from the standardization subcommittee of the International Continence Society. Urology. 2003;61:37–49.

    PubMed  Google Scholar 

  3. Salonia A, Zanni G, Briganti A, Deho F, Fabbri F, Colombo R, et al. Sexual dysfunction is common in women with lower urinary tract symptoms and urinary incontinence: results of a cross-sectional study. Eur Urol. 2004;45:642–8.

    PubMed  Google Scholar 

  4. Handa VL, Cundiff G, Chang HH, Helzsouer KJ. Female sexual function and pelvic floor disorders. Obstet Gynecol. 2008;111:1045–52.

    PubMed  PubMed Central  Google Scholar 

  5. Sarikaya S, Yildiz FG, Senocak C, Bozkurt OF, Karatas OF. Urinary incontinence as a cause of depression and sexual dysfunction: questionnaire-based study. Rev Int Androl 2018;pii: S1698-031X 30082-7. https://doi.org/10.1016/j.androl.2018.08.003.

  6. Roos AM, Thakar R, Sultan AH, Burger CW, Paulus AT. Pelvic floor dysfunction: womens’ sexual concerns unraveled. J Sex Med. 2014;11:743–52.

    PubMed  Google Scholar 

  7. Naeinian MR, Shaeiri MR, Hosseini FS. General health and quality of life in patients with sexual dysfunctions. Urol J. 2011;8:127–31.

    PubMed  Google Scholar 

  8. Lee DM, Tetley J, Pendleton N. Urinary incontinence and sexual health in a population sample of older people. BJU Int. 2018;122:300–8.

    PubMed  PubMed Central  Google Scholar 

  9. Thomas HN, Hamm M, Hess R, Thurston RC. Changes in sexual function among midlife women: ‘I’m older… and I’m wiser’. Menopause. 2018;25:286–92.

    PubMed  PubMed Central  Google Scholar 

  10. Maher CF, Baessler KK, Barber MD, Cheon C, Consten ECJ, Cooper KG, et al. Summary: 2017 international consultation on incontinence evidence-based surgical pathway for pelvic organ prolapse. Female Pelvic Med Reconstr Surg. 2018. https://doi.org/10.1097/SPV.0000000000000591.

    Article  PubMed  Google Scholar 

  11. Winkelman WD, Haviland MJ, Elkadry EA. Long-term pelvic symptoms, recurrence, satisfaction, and regret following colpocleisis. Female Pelvic Med Reconstr Surg. 2018. https://doi.org/10.1097/SPV.0000000000000602.

    Article  PubMed  Google Scholar 

  12. Thompson JC, Rogers RG. Surgical management of pelvic organ prolapse and its impact on sexual function. SexMed Rev. 2016;4:213–20.

    Google Scholar 

  13. Rogers RG, Pauls RN, Thakar R, Morin M, Kuhn A, Petri E, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for the assessment of sexual health of women with female pelvic floor dysfunction. Neurourol Urodyn. 2018;37:1220–40.

    PubMed  Google Scholar 

  14. El-Azab AS, Yousef HA, Seifeldein GS. Coital incontinence: relation to detrusor overactivity and stress incontinence. Neurourol Urodyn. 2011;30:520–4.

    PubMed  Google Scholar 

  15. Caruso S, Brescia R, Matarazzo MG, Giunta G, Rapisarda AMC, Cianci A. Effects of urinary incontinence subtypes on women’s sexual function and quality of life. Urology. 2017;108:59–68.

    PubMed  Google Scholar 

  16. Illiano E, Mahfouz W, Giannitsas K, Kocjancic E, Vittorio B, Athanasopoulos A. et al. Coital incontinence in women with urinary incontinence: an international study. J Sex Med. 2018; https://doi.org/10.1016/j.jsxm.2018.08.009.

    Article  PubMed  Google Scholar 

  17. Aslan G, Köseoğlu H, Sadik O, Gimen S, Cihan A, Esen A. Sexual function in women with urinary incontinence. Int J Impot Res. 2005;17:248–51.

    CAS  PubMed  Google Scholar 

  18. Salonia A, Briganti A, Deho F, Zanni G, Rigatti P, Montorsi F. Women’s sexual dysfunction: a review of the ‘surgical landscape’. Eur Urol. 2006;50:44–52.

    PubMed  Google Scholar 

  19. Moller LA, Lose G. Sexual activity and lower urinary tract symptoms. Int Urogynecol J Pelvic Floor Dysfunct. 2005;17:18–21.

    PubMed  Google Scholar 

  20. Chu CM, Arya LA, Andy UU. Impact of urinary incontinence on female sexual health in women during midlife. Women’s Midlife Health. 2015;1:6.

    PubMed  PubMed Central  Google Scholar 

  21. Haylen BT, De Ridder D, Freeman RM, Swift SE, Berghmans B, Lee J, et al. An International Urogynecology Association (IUGA)/International Continence Society (ICS) joint report on the terminology for pelvic floor dysfunction. Int Urogynecol J. 2010;21:5–26.

    PubMed  Google Scholar 

  22. Gutman RE, Ford DE, Quiroz LH, Shippey SH, Handa VL. Is there a pelvic organ prolapse threshold that predicts pelvic floor symptoms? Am J Obstet Gynecol. 2008;199:683.e1–683.e7.

    Google Scholar 

  23. Oksuz E, Malhan S. Kadin Cinsel Fonksiyon Indeksi: Turkce uyarlamasinin gecerlilik ve guvenilirlik analizi. Reliability and validity of the Female Sexual Function Index in a Turkish population. Syndrome. 2005;17:54–60.

    Google Scholar 

  24. Rosen R, Brown C, Heiman J, Leiblum S, Meston C, Shabsigh R, et al. The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital Ther. 2000;26:191–208.

    CAS  PubMed  Google Scholar 

  25. Cam C, Sancak P, Karahan N, Sancak A, Celik C, Karateke A. Validation of the short form of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) in a Turkish population. Eur J Obstet Gynecol Reprod Biol. 2009;146:104–7.

    PubMed  Google Scholar 

  26. Bilgic Celik D, Beji NK, Yalcin O. Turkish adaptation of the short form of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Function questionnaire (PISQ-12): a validation and reliability study. Neurourol Urodyn. 2013;32:1068–73.

    PubMed  Google Scholar 

  27. Rogers GR, Coates KW, Kammerer-Doak D, Khalsa S, Qualls C. A short form of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12). Int Urogynecol J. 2003;14:164–8.

    Google Scholar 

  28. Kelleher CJ, Cardozo LD, Khullar V, Salvatore S. A new questionnaire to assess the quality of life of urinary incontinent women. BJOG. 1997;104:1374–9.

    CAS  Google Scholar 

  29. Aslan E, Komurcu N, Beji NK, Yalcin O. Bladder training and Kegel exercises for women with urinary complaints living in a rest home. Gerontology. 2008;54:224–31.

    PubMed  Google Scholar 

  30. Dalpiaz O, Kerschbaumer A, Mitterberger M, Pinggera GM, Colleselli D, Bartsch G, et al. Female sexual dysfunction: a new urogynecological research field. BJU Int. 2008;101:717–21.

    PubMed  Google Scholar 

  31. Çayan S, Yaman Ö, Orhan I, Usta M, Başar M, Resim S, et al. Prevalence of sexual dysfunction and urinary incontinence and associated risk factors in Turkish women. Eur J Obstet Gynecol Reprod Biol. 2016;203:303–8.

    PubMed  Google Scholar 

  32. Gozuyesil E, Gokyildiz Surucu S, Alan S. Sexual function and quality of life related problems during the menopausal period. H Health Psychol. 2018;23:1769–80.

    Google Scholar 

  33. Ambler DR, Bieber EJ, Diamond MP. Sexual function in elderly women: a review of current literature. Rev Obstet Gynecol. 2012;5:16–27.

    PubMed  PubMed Central  Google Scholar 

  34. Dombek K, Capistrano EJ, Costa AC, Marinheiro LP. Risk factors associated with sexual dysfunction in Brazilian postmenopausal women. Int J Impot Res. 2016;28:62–67.

    CAS  PubMed  Google Scholar 

  35. Duralde ER, Rowen TS. Urinary incontinence and associated female sexual dysfunction. Sex Med Rev. 2017;5:470–85.

    PubMed  Google Scholar 

  36. Handelzalts JE, Yakoobi T, Levy S, Peled Y, Wiznitzer A, Krissi H. The impact on genital self-image on sexual function in women with pelvic floor disorders. Eur J Obstet Gynecol Reprod Biol. 2017;211:164–8.

    PubMed  Google Scholar 

  37. Fashokun TB, Harvie HS, Schimpf MO, Olivera CK, Epstein LB, Jean-Michel M, et al. Sexual activity and function in women with and without pelvic floor disorders. Int Urogynecol J. 2013;24:91–7.

    PubMed  Google Scholar 

  38. Grzybowska ME, Wydra D. Predictors of sexual function in women with stress urinary incontinence. Neurourol Urodyn. 2018;37:861–8.

    PubMed  Google Scholar 

  39. Felippe MR, Zambon JP, Girotti ME, Burti JS, Hacad JR, Cadamuro L, et al. What is the real impact of urinary incontinence on female sexual dysfunction? A case control study. Sex Med. 2017;5:e54–e60.

    PubMed  PubMed Central  Google Scholar 

  40. Dennerstein L, Guthrie JR, Hayes RD, DeRogatis LR, Lehert P. Sexual function, dysfunction, and sexual distress in a prospective, population-based sample of middle-aged Australian-born women. J Sex Med. 2008;5:2291–9.

    PubMed  Google Scholar 

  41. Leiblum SR, Koochacki PE, Rodenberg CA, Barton IP, Rosen RC. Hypoactive disorder in postmenopausal women: US Results from the Women’s International Study of Health and Sexuality (WISHeS). Menopause. 2006;13:46–56.

    PubMed  Google Scholar 

  42. Juliato CRT, Melotti IGR, Santos LC Jr, Britto LGO, Riccetto CLZ. Does the severity of overactive bladder symptoms correlate with risk for female sexual dysfunction? J Sex Med. 2017;14:904–9.

    PubMed  Google Scholar 

  43. Serati M, Salvatore S, Uccella S, Cromi A, Khullar V, Cardozo L, et al. Urinary incontinence at orgasm: relation to detrusor activity and treatment efficacy. Eur Urol. 2008;54:911–7.

    PubMed  Google Scholar 

  44. Jha S, Strelley K, Radley S. Incontinence during intercourse: myths unravelled. Int Urogynecol J. 2012;23:633–7.

    PubMed  Google Scholar 

  45. Gray T, Li W, Campbell P, Jha S, Radley S. Evaluation of coital incontinence by electronic questionnaire: prevalence, associations and outcomes in women attending a urogynecology clinic. Int Urogynecol J. 2018;29:969–78.

    PubMed  Google Scholar 

  46. Grzybowska ME, Wydra DG. Coital incontinence: a factor for deteriorated health related quality of life and sexual function in women with urodynamic stress urinary incontinence. Int Urogynecol J. 2017;28:697–704.

    PubMed  Google Scholar 

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Correspondence to Funda Gungor Ugurlucan.

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Ugurlucan, F.G., Evruke, I., Yasa, C. et al. Sexual functions and quality of life of women over 50 years with urinary incontinence, lower urinary tract symptoms and/or pelvic organ prolapse. Int J Impot Res 32, 535–543 (2020). https://doi.org/10.1038/s41443-019-0219-7

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