Predictors of sexual function in women with stress urinary incontinence

[Clinical path and life quality of women under 75 years with an urinary incontinence relevant to surgical treatment]

OBJECTIVES

Urinary incontinence has a high prevalence and a significant impact on quality of life, especially for women. Surgery is possible after failure of lifestyle changes, physiotherapy. Analyzing the care pathway of women under 75 years of age who have undergone surgery for urinary incontinence in link with recommendation and suggest possible improvements.

METHODS

Quantitative, multicentric, retrospective survey carried out between 10/09/2019 and 25/11/2019, based on anonymous self-report questionnaire, among women aged between 32 and 75 and operated in different hospitals in Loire (France).

RESULTS

Ninety-three answers were exploited out of 204. Among the women, 49.5 % had stress, 50.5 % mixed incontinence. Before the intervention, it had evolved for 5 years on average and caused discomfort evaluated at an average 7.5/10. Eighty percent frequently used protective pads and bladder training. Lifestyle changes and the voiding diary were not used much. Eighty-six percent of women felt comfortable to speak to a physician. Seventy-three percent had performed a urodynamic test, 47 % an abdominal ultrasound and 40 % a urinalysis. Seventy-seven percent performed physiotherapy, 39 % self-administered physiotherapy, 7 % used medication. The postoperative quality of life was evaluated at 7.8/10; 58 % felt healed and 69 % considered their sex life had improved.

CONCLUSIONS

The care pathway could be improved through systematic screening for urinary incontinence and its impact. The development of a care plan to coordinate and propose quick care could help patients to improve their life.

Association between sexual intercourse frequency and pelvic floor muscle morphology in pregnant women

INTRODUCTION AND HYPOTHESIS

No studies have been performed to examine the association of sexual activity and pelvic floor muscle (PFM) morphology or function during pregnancy. The aim of this study was to survey the frequency of sexual intercourse and examine the associations between the frequency of sexual intercourse and the PFM morphology in pregnant women of mainland China. The relationship between sexual intercourse frequency and stress urinary incontinence (SUI)-related symptoms was also evaluated.

METHODS

Pregnant women in their first or second trimester were enrolled from January 2017 and November 2017. The morphology of the PFM was examined by transperineal ultrasound, and SUI-related symptoms were assessed by the International Consultation of Incontinence Questionnaire-Short Form (ICIQ-SF). Multivariable regression analyses were used to estimate coefficients [95% confidence intervals (CI)] with adjustment for the possible effects of cofounders.

RESULTS

In total, 323 pregnant women (mean age, 29.66 ± 4.32 years) were included in the analysis. Almost 49% of the women had no sexual intercourse during pregnancy. Compared with pregnant women who had no sexual intercourse, those who had sexual intercourse more than once a month had stronger LA th at rest (β = 0.59, P = 0.004 for two or three times per month; β = 0.59, P = 0.044 for weekly or more). No significant relationship was found between the frequency of sexual intercourse and any ICIQ-SF-related items.

CONCLUSIONS

Chinese women had inactive sexual intercourse during pregnancy. There is a slight association between increased sexual intercourse frequency and a thicker levator ani muscle in pregnant women. Future work may be directed at determining the causality of this association.

Prevalence and risk factors of sexual dysfunction in healthy women in Turkey

OBJECTIVES

This is a cross sectional study conducted in order to determine sexual dysfunction in healthy women and risk factors.

PATIENTS AND METHODS

The population of the study consisted of 282 women. The whole of the population, without sample selection, was included in the study. For data, questionnaire and Female Sexual Function Index-FSFI, whose Turkish validity and reliability study was conducted, were used. Student t and chi-square significant tests and logistic regression analysis were used to carry out statistical analysis.

RESULTS

It was found that 35.8% of 282 women who participated in the study were in the age range of 30-39 years, 54.6% had high school educational level or above, and 59.6% worked. Prevalence was determined as 53.2% FSFI score < 26 according to Female Sexual Function Index FSFI; 23% of the women had complaints about urinary incontinence UI. According to logistic regression results, it is determined that CFB risk is increased in patients with age and urination problem. It was determined that there was no significant correlation between income, number of children, prceived economic status, dyspareunia, having problem with the partner, experiencing premenstrual syndrome, and SD.

CONCLUSION

In this study, approximately half of healthy women had SD and development of SD was affected based on some descriptive characteristics. As sexual life was considered as a factor increasing life quality, it was thought that it is fairly important to discuss the questioning of problems related to sexual life for systematic evaluation of patients, as well.

Is voluntary pelvic floor muscles contraction important for sexual function in women with pelvic floor disorders?

AIMS

To investigate relationships between pelvic floor muscles (PFM) and sexual function (SF) in sexually active (SA) and not-SA (NSA) women with pelvic floor disorders (PFD).

METHODS

In 350 women with PFD: 173 (49.4%) SA, 177 (50.6%) NSA, Pelvic Organ Prolapse (POP)-Quantification, PFM tone, and strength were evaluated. Transperineal ultrasound (TPS) measured genital hiatus (GH) diameter, bladder neck (BN) movement. Pelvic Organ Prolapse/Incontinence Sexual Questionnaire, IUGA-Revised (PISQ-IR), and Female Sexual Function Index (FSFI) were used. SA women were dichotomized according to muscle strength (weak/strong) and tone (normal/hypoactive).

RESULTS

FSFI scores reflected sexual dysfunction in 63.5% SA women. 32.2% partnered NSA stated PFD the reason for sexual inactivity. NSA women had higher POP stages and hypoactive PFM rates compared to SA: 72 (40.7%) vs 52 (30.1%), P = .04. TPS GH diameter did not differ between SA and NSA at rest, contraction, and did not correlate with SF. BN length was longer in SA at rest (15.0 ± 7.0 vs 13.1 ± 9.4, P = .03) and contraction (19.7 ± 7.0 vs 16.7 ± 10.2, P = .006); 30 (8.6%) subjects depressed BN during contraction. GH change at contraction correlated with Oxford Grading Scale (r_ps  = 0.41; P < .001), and was smaller in women with nonfunctioning vs normal/underactive PFM (P < .001). Women with hypoactive PFM had lower SF in PISQ-IR Global quality and FSFI Desire domains vs normal tone. BN length at rest, contraction, and total mobility correlated with several PISQ-IR and FSFI domains.

CONCLUSIONS

In SA women with PFD, lower rates of hypoactive PFM tone were found. The ability to contract PFM did not influence SF. Greater mobility of BN correlated with lower SF.