Urine leakage during sexual activity among ethnically diverse, community-dwelling middle-aged and older women

Effect of cognitive-behavioral therapy on sexual self-esteem and sexual function of reproductive-aged women suffering from urinary incontinence

INTRODUCTION

Patients with urinary incontinence may fear sexual activity due to the unpredictability of urine leakage during intercourse. Given the effective role of cognitive-behavioral therapy in correcting negative thoughts and attitudes, this study was aimed to investigate the effect of cognitive-behavioral therapy on sexual self-esteem and sexual function of reproductive-aged women suffering from urinary incontinence.

METHODS

This study was a randomized controlled clinical trial conducted on 84 reproductive-aged women (18 to 45 years old) with urinary incontinence who referred to Health Centers of Dezful, Iran. After random allocation, the participants were divided into two groups of intervention and control (n = 42). The intervention group attended eight 45-min sessions of cognitive-behavioral therapy, while the control group received only routine interventions. The International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), the Scale of Self-Esteem Index for Women-Short-form (SSEL-W-SF), and the Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire (PISQ-12) were completed before, immediately after, and 4 weeks after the end of the intervention by patients in both groups.

RESULTS

The overall scores of sexual self-esteem and sexual function immediately and 4 weeks after the end of the intervention showed a statistically significant difference in the intervention group compared to the control group (p < 0.001). Also, the results showed that in women with urinary incontinence, an increase in the sexual self-esteem score is associated with an increase in the sexual function score (r = 0.9), p < 0.001).

CONCLUSION

Cognitive-behavioral therapy was found to increase sexual self-esteem and improve sexual function in reproductive-aged women suffering from urinary incontinence.

Comparative Assessment of Female Sexual Function Following Transobturator Midurethral Sling for Stress Urinary Incontinence

Urinary incontinence (UI) is a significant social problem. According to the World Health Organization, UI affects as much as 30% of premenopausal women and 60% of postmenopausal women. Urinary incontinence can lead to certain problems that negatively affect a woman's sex life. They result from the fact that certain processes take place in the body during intercourse. As a result of orgasm, the intra-abdominal pressure increases, which in women with urinary incontinence can cause an uncontrolled leakage of urine. The discomfort that this causes, in turn, lowers sexual attractiveness, as well as causes embarrassment. The study involved 50 patients hospitalized in the period from February to May 2019 at the Gynecology Department of the Independent Public Healthcare Center of the Ministry of the Interior and Administration in Wrocław. All patients underwent surgical treatment of stress urinary incontinence using the transobturator tape (TOT) method. To assess sexuality, the international standardized Female Sexual Function Index (FSFI) questionnaire. Analysis of the results obtained from the FSFI questionnaire shows that the operation significantly affects the reduction in pain sensation during intercourse, a reduction in the sensation of sexual arousal, and a worsening vaginal wetness. Stress urinary incontinence significantly affects women's sex life.

Effect of health literacy on help-seeking behavior: A comparison of patients accepting surgery and refusing surgery for urinary incontinence

OBJECTIVE(S)

To compare the health literacy (HL) of the adult females with SUI complaints in terms of their acceptance or non-acceptance of surgery.

METHODS

In this cohort study, the European Health Literacy Survey Questionnaire (HLS-EU- Q47) scores as a measure of health literacy were compared among the two groups of patients who accepted to undergo surgery for SUI and the ones who did not. Demographic features, weight and BMI values, comorbidity, menopausal status, duration and type of UI, socioeconomic characteristics (marital status, educational level, level of income) and HLS-EU- Q47 survey results of the two groups were compared. We also investigated the reasons regarding the acceptance or refusal of SUI surgery.

RESULTS

Among the patients who were offered surgery 474% accepted to undergo operation. Total HLS-EU-Q47 score was 30.04 in the group of patients who accepted surgery and 23.46 in the group who refused surgery. The patients that refused surgery had more often insufficient health literacy level (p=0.001). An excellent health literacy level was higher for patients who agreed to anti-incontinence surgery (p=0.021).

CONCLUSIONS

Health literacy score of patients with urinary incontinence (UI) who refused surgery was lower than those who accepted surgery. Acceptance of surgery may be increased by providing more understandable and clear information, especially for women with lower HL levels.

Development and validity of a questionnaire for coital urinary incontinence: clinical and urodynamic analysis

INTRODUCTION AND HYPOTHESIS

To develop and validate a questionnaire (coital incontinence questionnaire-CIQ) for CI and perform clinical and urodynamic analysis of patients with CI.

METHODS

A total of 414 female patients with urinary incontinence undergoing urodynamics were included in this study. All patients were evaluated with a detailed history, questionnaires, physical examination, relevant laboratory tests and urodynamics. Content, construct and convergent validity of the questionnaire were evaluated. Patients were divided into groups: with CI (group 1) and without CI (group 2).

RESULTS

Overall test-retest reliability coefficients of CIQ were high (r = 0.968, p = 0.01), and the internal consistency was excellent (Cronbach's alpha, 0.964). The test-retest scores did not show a statistically significant difference (p = 0.158). Approximately 34% of these women had CI. Body mass index (BMI), parity, daily incontinence episodes, daily pad counts and 1-h pad test results were higher in group 1 than group 2 (p < 0.05). Multivariate analysis revealed that a daily incontinence episode, BMI, maximum cystometric capacity and PdetQmax were statistically significant factors associated with CI. Urinary incontinence types were different between groups (p < 0.0001). Incontinence with both penetration and orgasm was the most common form of CI (54.4%), and CI severity differed significantly among the forms of CI (p = 0.007). CI negatively interferes with patients' sexual life, their relationship with their partner and quality of life in most patients.

CONCLUSIONS

The CIQ is a reliable, valid and useful tool for assessment of all aspects of CI in women. CI seems to be related to the severity of urinary incontinence. Further studies are needed to clarify this subject.