1
|
Ali MU, Fong KNK, Kannan P, Bello UM, Kranz G. Effects of nonsurgical, minimally or noninvasive therapies for urinary incontinence due to neurogenic bladder: a systematic review and meta-analysis. Ther Adv Chronic Dis 2022; 13:20406223211063059. [PMID: 35321402 PMCID: PMC8935404 DOI: 10.1177/20406223211063059] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 11/10/2021] [Indexed: 12/18/2022] Open
Abstract
Objective To determine the effects of nonsurgical, minimally or noninvasive therapies on urge urinary incontinence (UUI) symptoms and quality of life (QoL) in individuals with neurogenic bladder (NGB). Data Sources Cochrane library, EMBASE, MEDLINE, PEDro, Scopus, and Web of Science databases were searched from inception to September 2021. Review Methods Randomized controlled trials that compared therapies such as intravaginal electrical stimulation (IVES), transcutaneous electrical nerve stimulation (TENS), neuromuscular electrical stimulation (NMES), transcutaneous tibial nerve stimulation (TTNS), pelvic floor muscle training (PFMT), and behavioural therapy (BT) to control were included. Study screening, data extraction, and study quality assessments were performed by two independent authors. Results Fourteen trials with 804 participants were included in the study after screening of 4281 potentially relevant articles. Meta-analyses revealed a significant effect of electrical stimulation on UUI due to multiple sclerosis (standardized mean difference (SMD): -0.614; 95% confidence interval (CI): -1.023, -0.206; p = 0.003) and stroke (SMD: -2.639; 95% CI: -3.804, -1.474; p = 0.000). The pooled analyses of TTNS (weighted mean difference (WMD): -12.406; 95% CI: -16.015, -8.797; p = 0.000) and BT (WMD: -9.117; 95% CI: -14.746, -3.487; p = 0.002) revealed significant effects of these interventions on QoL in people with Parkinson's disease. However, meta-analyses revealed nonsignificant effects for PFMT (WMD: -0.751; 95% CI: -2.426, 0.924; p = 0.380) and BT (WMD: -0.597; 95% CI: -1.278, 0.083; p = 0.085) on UUI due to Parkinson's disease. Conclusions Our meta-analyses found electrical stimulation to be beneficial for improving the symptoms of UUI among people with multiple sclerosis and those with stroke. Our review also revealed that TTNS and BT might improve QoL for people with NGB due to Parkinson's disease, although the effects of PFMT and BT on UUI warrant further investigation.
Collapse
Affiliation(s)
- Mohammed Usman Ali
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong Department of Medical Rehabilitation (Physiotherapy), University of Maiduguri, Maiduguri, Nigeria
| | - Kenneth Nai-Kuen Fong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Priya Kannan
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Umar Muhammad Bello
- Centre for Eye and Vision Research (CEVR) Limited, Hong Kong, China; Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong Department of Physiotherapy, Yobe State University Teaching Hospital, Damaturu, Nigeria
| | - Georg Kranz
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| |
Collapse
|
2
|
Phé V, Gamé X. [Definition, epidemiology and impact of non-neurogenic overactive bladder]. Prog Urol 2021; 30:866-872. [PMID: 33220814 DOI: 10.1016/j.purol.2020.09.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 08/10/2020] [Accepted: 09/04/2020] [Indexed: 12/26/2022]
Abstract
INTRODUCTION Overactive bladder (OAB) is a common condition with a significant functional impact in patients. OBJECTIVE To synthesize current knowledge on the definition, epidemiology and impact of OAB. METHOD A systematic literature review based on Pubmed, Embase, Google Scholar was conducted in June 2020. RESULTS OAB is defined by urinary urgency, usually accompanied by frequency and nocturia, with or without urgency urinary incontinence, in the absence of urinary tract infection or other obvious pathology. In France, OAB affects 14 % of the general population and this prevalence increases with age. This condition is a source of major deterioration in patients' quality of life with a physical (falls, fractures, sleep disorders, fatigue), psychic (anxiety, depression) social (limitation of leisure, isolation) and economic impact. CONCLUSION The definition of OAB is standardized. OAB is a frequent condition and has significant functional consequences with a notable deterioration in quality of life.
Collapse
Affiliation(s)
- V Phé
- Sorbonne université, service d'urologie, hôpital Pitié-Salpêtrière, assistance publique-hôpitaux de Paris, Paris, France.
| | - X Gamé
- Département d'urologie, transplantation rénale et andrologie, CHU de Rangueil, université Paul-Sabatier, Toulouse, France
| |
Collapse
|
3
|
Özcan A, Avci İA. Impact of Urinary Incontinence on Quality of Life Among Older Adults Living in a Rural Area of Turkey. J Gerontol Nurs 2021; 47:43-52. [PMID: 34044687 DOI: 10.3928/00989134-20210510-03] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The current study aimed to identify the frequency of urinary incontinence (UI), its effects on quality of life, and risk factors in older adults living in rural areas of Turkey. For this descriptive study, 400 older adults aged 65 to 96 years were interviewed. Data were collected using a sociodemographic form and the Incontinence-Quality of Life Scale (I-QOL). Among those interviewed, 56.3% experienced UI. Logistical regression analysis revealed chronic illness, gender, and level of education as risk factors for UI. Significantly lower (p < 0.05) I-QOL scores were found for older adults having UI, holding urine, leaking urine while coughing/sneezing, involuntarily urinating more than once per day, or wetting themselves. Most participants did not seek help, citing embarrassment or viewing UI as normal. UI significantly reduces older adults' quality of life. Educational and consultation services, especially for older, illiterate, married women with chronic illness, would help these individuals sustain healthy lives. [Journal of Gerontological Nursing, 47(6), 43-52.].
Collapse
|
4
|
Hwang UJ, Lee MS, Jung SH, Ahn SH, Kwon OY. Relationship Between Sexual Function and Pelvic Floor and Hip Muscle Strength in Women With Stress Urinary Incontinence. Sex Med 2021; 9:100325. [PMID: 33662705 PMCID: PMC8072144 DOI: 10.1016/j.esxm.2021.100325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 01/06/2021] [Accepted: 01/12/2021] [Indexed: 10/26/2022] Open
Abstract
INTRODUCTION The pelvic floor muscle (PFM) could affect female sexual functions. The hip muscles are morphologically and functionally linked to PFM and are important elements of female sexual attraction. AIM To determine the relationship between female sexual function and hip muscle strength and PFM functions in women with stress urinary incontinence (SUI). METHODS A total of 42 women with SUI were recruited in this study. Female sexual function was measured using the pelvic organ prolapse urinary incontinence sexual function questionnaire (PISQ). PFM functions were measured using a perineometer. Hip muscle strength was measured using a Smart KEMA tension sensor. The relationship between female sexual function and PFM function and hip muscle strength was assessed using Pearson correlation coefficients and multiple regression analyses with forward selection. MAIN OUTCOME MEASURES PISQ score, PFM functions (strength and endurance), and strength of hip extensor, abductor, and adductor were the main outcome measures. RESULTS For the behavioral/emotive domain in the PISQ, hip extensor strength (r = 0.452), PFM strength (r = 0.441), PFM endurance (r = 0.362), and hip adductor strength (r = 0.324) were significantly correlated and hip extensor strength emerged in multiple regression. For the physical domain in the PISQ, hip abductor strength (r = 0.417), PFM endurance (r = 0.356), hip adductor strength (r = 0.332), and PFM strength (r = 0.322) were significantly correlated and hip abductor strength entered in multiple regression. For partner-related domain in the PISQ, hip adductor (r = 0.386) and abductor strength (r = 0.314) were significantly correlated and hip adductor strength appeared in multiple regression. For the PISQ total score, hip extensor strength (r = 0.484), PFM endurance (r = 0.470), hip adductor strength (r = 0.424), hip abductor strength (r = 0.393), and PFM strength (r = 0.387) were significantly correlated and hip extensor strength and PFM endurance emerged in multiple regression. CONCLUSION The female sexual function could be related to not only PFM functions but also hip muscle strength in women with SUI. Hwang UJ, Lee MS, Jung SH, Ahn SH, Kwon OY. Relationship Between Sexual Function and Pelvic Floor and Hip Muscle Strength in Women With Stress Urinary Incontinence. Sex Med 2021;9:100325.
Collapse
Affiliation(s)
- U J Hwang
- Department of Physical Therapy, Graduate School, Yonsei University, Wonju, South Korea
| | - M S Lee
- Sophie-Marceau Women's Clinic, Daegu, South Korea
| | - S H Jung
- Department of Physical Therapy, Graduate School, Yonsei University, Wonju, South Korea
| | - S H Ahn
- Department of Physical Therapy, Graduate School, Yonsei University, Wonju, South Korea
| | - O Y Kwon
- Department of Physical Therapy, College of Health Science, Laboratory of Kinetic Ergocise Based on Movement Analysis, Yonsei University, Wonju, South Korea.
| |
Collapse
|
5
|
Yang E, Hu SW, Chen SL, Chen GD, Ng SC. A 3-year longitudinal survey of overactive bladder in community-dwelling male residents aged 40 years and above. Low Urin Tract Symptoms 2021; 13:356-360. [PMID: 33594797 DOI: 10.1111/luts.12375] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 01/22/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To evaluate the short-term evolution and risk factors of overactive bladder (OAB) in community-dwelling male residents aged 40 years and above in central Taiwan. METHODS This was a 3-year longitudinal cohort study. From January 2012 to December 2012, community residents aged 40 years and above, living in central Taiwan, were invited to participate in this study. A yearly Overactive Bladder Symptom Score (OABSS) questionnaire was used to assess the prevalence, incidence, remission, persistence, and relapse of OAB for three consecutive years. OAB was defined as total OABSS ≧4 and urgency score ≧2. RESULTS Nine hundred forty-one male residents aged ≧40 years were recruited. The prevalence of OAB was 15%. The male residents with OAB were older, had a history of urological surgery, were unemployed, had lower educational levels, and lower yearly incomes compared with male residents without OAB. The prevalence increased with age when stratified into different age cohorts (40-49, 7%; 50-59, 12.7%; 60-69, 18.2%; ≧70, 32%; P < .001). Age ≧60 (odds ratio [OR] 2.58; 95% CI, 1.62-4.11) and history of urological surgery (OR 2.85; 95% CI, 1.29-6.30) were the major risk factors after multivariable logistic regression analysis. Eight hundred participants completed all the 3 years' questionnaires. The second- and third-year incidence rates of OAB were 10% (69/691) and 6.2% (42/674), respectively. The remission rates were 47.7% (52/109) and 46% (58/126), respectively. The two-year OAB persistence rate was 30.3% (33/109). CONCLUSIONS The prevalence and yearly incidence of OAB are high in community-dwelling male residents aged ≧40 years in central Taiwan. Age is an important risk factor.
Collapse
Affiliation(s)
- Evelyn Yang
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan.,School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Suh-Woan Hu
- Institute of Oral Sciences, Chung Shan Medical University, Taichung, Taiwan
| | - Sung-Lang Chen
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan.,Department of Urology, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Gin-Den Chen
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Soo-Cheen Ng
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan.,School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| |
Collapse
|
6
|
Wang Y, Shi C, Wang Y, Jiao W, Wang X, Zhang J, Shi G, Wu D. The Correlation between Severity of Overactive Bladder Symptoms with Female Sexual Dysfunction and Sexual Satisfaction of Partners. Urol Int 2020; 105:124-130. [PMID: 33176322 DOI: 10.1159/000508764] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 05/16/2020] [Indexed: 11/19/2022]
Abstract
PURPOSE Sexual dysfunction in women with overactive bladder (OAB) syndrome has been an important topic, while the sexual satisfaction of partners has not been fully investigated. Our aim was to explore the association between the severity of OAB with female sexual dysfunction and sexual satisfaction of partners. METHODS A total of 323 patients with OAB recruited in our hospital were included in our study from September 2017 to March 2019. Data were collected by Overactive Bladder Symptom Score (OABSS) questionnaire, self-designed questionnaire for basic characteristics; Female Sexual Function Index (FSFI); and sexual satisfaction survey for sex partners of patients. χ2 test or 1-way ANOVA was used to compare the variables among groups. Logistic regression analysis was performed to analyze the severity of OAB with female sexual dysfunction and sexual satisfaction of partners. The correlations between different OABSS domains with female sexual dysfunction and sexual satisfaction of partners were assessed. RESULTS All the patients were classified into mild (n = 107), moderate (n = 98), severe (n = 118) OAB group based on OABSS. Most of the basic information were similar among groups, except for BMI, highest education, occupation, fertility, and history of pelvic floor surgery. After multiple factors correction, the severity of OAB, exercise frequency, and the history of pelvic floor surgery were statistically associated with the female sexual dysfunction and sexual satisfaction of partners. Urgency score was significantly correlated with female sexual dysfunction, and the urge incontinence was most significantly associated with the sexual satisfaction of partners. CONCLUSION Severe OAB was closely associated with female sexual dysfunction and sexual satisfaction of partners. The urgency and urge incontinence should be focused for OAB management.
Collapse
Affiliation(s)
- Yangyun Wang
- Tongji Hospital, Tongji University School of Medicine, Shanghai, China
| | - Chaoliang Shi
- Department of Urology, The Fifth People's Hospital of Shanghai, Fudan University, Shanghai, China
| | - Yang Wang
- Department of Urology, The Fifth People's Hospital of Shanghai, Fudan University, Shanghai, China
| | - Wei Jiao
- Department of Urology, The Fifth People's Hospital of Shanghai, Fudan University, Shanghai, China
| | - Xilong Wang
- Department of Urology, The Fifth People's Hospital of Shanghai, Fudan University, Shanghai, China
| | - Jun Zhang
- Department of Urology, The Fifth People's Hospital of Shanghai, Fudan University, Shanghai, China
| | - Guowei Shi
- Department of Urology, The Fifth People's Hospital of Shanghai, Fudan University, Shanghai, China
| | - Denglong Wu
- Department of Urology, Tongji Hospital, Tongji University School of Medicine, Shanghai, China,
| |
Collapse
|
7
|
Effects of surface electrical stimulation during sitting on pelvic floor muscle function and sexual function in women with stress urinary incontinence. Obstet Gynecol Sci 2020; 63:370-378. [PMID: 32489983 PMCID: PMC7231947 DOI: 10.5468/ogs.2020.63.3.370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 10/21/2019] [Accepted: 11/06/2019] [Indexed: 11/08/2022] Open
Abstract
Objective Dysfunction of the pelvic floor muscles (PFM) is associated with sexual dysfunction in women with stress urinary incontinence (SUI). The EasyK7 device was developed to stimulate the PFM by surface electrical stimulation during sitting (SESdS). We investigated the effects of SESdS on PFM function and sexual function in women with SUI. Methods Women with SUI were randomized into the SESdS and control groups. PFM function and sexual function were assessed using a perineometer and the pelvic organ prolapse–urinary incontinence sexual function questionnaire (PISQ), respectively. After 8 weeks, the groups were compared using either analysis of covariance with the baseline values as covariates or the paired Student's t-test. Results The final analysis included 16 subjects from each group. There were significant differences between the SESdS and control groups after the intervention, as well as within the SESdS group between the pre- and post-intervention measurements. The P-values for the differences in PFM measurements between the groups, and between the pre- and post- intervention measurements within the SESdS group, were 0.001 and 0.004 for power, 0.015 and 0.011 for strength, and 0.012 and 0.034 for endurance, respectively. In addition, in the PISQ, there were significant differences between the groups and between the pre- and post-intervention measurements within the SESdS group in the partner-related domain (between groups: P=0.003; within SESdS group: P=0.024) and total score (between groups: P<0.001; within SESdS group: P=0.001). Conclusion SESdS can improve PFM function and sexual function in women with SUI. Trial Registration Clinical Research Information Service Identifier: KCT0003357
Collapse
|
8
|
La Rosa VL, Duarte de Campos da Silva T, Rosa de Oliveira A, Marques Cerentini T, Viana da Rosa P, Telles da Rosa LH. Behavioral therapy versus drug therapy in individuals with idiopathic overactive bladder: A systematic review and meta-analysis. J Health Psychol 2019; 25:573-585. [PMID: 31793816 DOI: 10.1177/1359105319891629] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The aim of this study was to systematically review randomized clinical trials comparing the treatment of individuals with overactive bladder syndrome through the use of behavioral therapy versus drug therapy. A systematic electronic search of MEDLINE via PubMed, Embase, and Cochrane Library was performed, including studies indexed until August 2019. Five randomized clinical trials were included. The studies presented a high risk of bias. There was no significant difference between the evaluated treatments. Thus, behavioral therapy and drug therapy also promote the improvement of the symptoms of overactive bladder syndrome, and the behavioral therapy does not have significant adverse effects reported. Due to the high risk of bias in included studies, data should be interpreted with caution. Future studies with more comprehensive protocols may change the effect estimates of behavioral therapy on overactive bladder syndrome.
Collapse
|
9
|
Hwang UJ, Lee MS, Jung SH, Ahn SH, Kwon OY. Pelvic Floor Muscle Parameters Affect Sexual Function After 8 Weeks of Transcutaneous Electrical Stimulation in Women with Stress Urinary Incontinence. Sex Med 2019; 7:505-513. [PMID: 31563553 PMCID: PMC6963109 DOI: 10.1016/j.esxm.2019.08.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 08/08/2019] [Accepted: 08/27/2019] [Indexed: 10/25/2022] Open
Abstract
INTRODUCTION Stress urinary incontinence (SUI) is often associated with female sexual dysfunction. We investigated which pelvic floor muscle (PFM) parameters (strength, power, and endurance) are associated with improvement of sexual function after 8 weeks of transcutaneous electrical stimulation (TES) training. AIM This study was performed to determine the effects of TES in the seated position on PFM parameters and female sexual function and to identify correlation between improved PFM parameters and sexual function after 8 weeks of TES training in women with SUI. METHODS The present study was performed between August 2018 and November 2018 in women with SUI who were randomized into a TES group (n = 17) or a control group (n = 17). One subject in each of the TES and control groups ultimately withdrew during the intervention due to a lack of time. Both groups were measured at baseline and after 8 weeks of intervention. MAIN OUTCOME MEASURE As outcome measures, PFM parameters (strength, power, and endurance) and female sexual function were assessed using a perineometer and the Female Sexual Function Index (FSFI), respectively. RESULTS The final study population consisted of 32 women with SUI. There were significant differences in PFM strength, power, and endurance and FSFI domain scores (desire, arousal, orgasm, satisfaction, and total score) in both between-group analyses (TES vs control group) and within-group analyses (pre-TES vs post-TSE). Change in PFM endurance had the highest association with change in total FSFI total score (r = 0.437; P = .006), and change in PFM power had the highest association with change in FSFI satisfaction (r = 0.420; P = .008). CONCLUSION TES in a seated position showed a beneficial effect on sexual function in females with SUI. Consideration of PFM parameters associated with FSFI domain scores may be important when developing intervention guidelines to improve female sexual function. Hwang UJ, Lee MS, Jung SH, et al. Pelvic Floor Muscle Parameters Affect Sexual Function After 8 Weeks of Transcutaneous Electrical Stimulation in Women with Stress Urinary Incontinence. Sex Med 2019;7:505-513.
Collapse
Affiliation(s)
- Ui-Jae Hwang
- Laboratory of Kinetic Ergocise Based on Movement Analysis, Department of Physical Therapy, College of Health Science, Yonsei University, Heungeop-myun, Wonju, South Korea
| | - Min-Seok Lee
- Sophie-Marceau Women's Clinic, Daegu, South Korea
| | - Sung-Hoon Jung
- Laboratory of Kinetic Ergocise Based on Movement Analysis, Department of Physical Therapy, College of Health Science, Yonsei University, Heungeop-myun, Wonju, South Korea
| | - Sun-Hee Ahn
- Laboratory of Kinetic Ergocise Based on Movement Analysis, Department of Physical Therapy, College of Health Science, Yonsei University, Heungeop-myun, Wonju, South Korea
| | - Oh-Yun Kwon
- Laboratory of Kinetic Ergocise Based on Movement Analysis, Department of Physical Therapy, College of Health Science, Yonsei University, Heungeop-myun, Wonju, South Korea.
| |
Collapse
|
10
|
Elnaggar A, Chendrimada M, Viji M, Dua A. Variations in implementation of bladder training for overactive bladder: an online international survey. J OBSTET GYNAECOL 2019; 40:684-687. [DOI: 10.1080/01443615.2019.1647526] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Ahmed Elnaggar
- Department of Obstetrics Gynaecology, University of Plymouth Hospital NHS, Plymouth, UK
| | - Madhu Chendrimada
- Department of Obstetrics Gynaecology, Southmead Hospital, North Bristol NHS Trust, Bristol, UK
| | - Monika Viji
- Department of Obstetrics Gynaecology, Southmead Hospital, North Bristol NHS Trust, Bristol, UK
| | - Anu Dua
- Department of Obstetrics Gynaecology, Southmead Hospital, North Bristol NHS Trust, Bristol, UK
| |
Collapse
|
11
|
A comparison of sacral neuromodulation vs. transvaginal electrical stimulation for the treatment of refractory overactive bladder: the impact on quality of life, body image, sexual function, and emotional well-being. MENOPAUSE REVIEW 2019; 18:89-93. [PMID: 31485205 PMCID: PMC6719634 DOI: 10.5114/pm.2019.86834] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Accepted: 06/17/2019] [Indexed: 02/04/2023]
Abstract
Overactive bladder syndrome (OAB) is defined by the presence of urinary urgency, with or without urge incontinence, usually accompanied by an increase in urinary frequency and nocturia in the absence of urinary tract infections (UTI) or other diseases. The overall prevalence of OAB symptoms in the female population is reported to be 16.6% and increases with advancing age and menopause. The aetiology of OAB is not fully understood and is likely to affect a heterogeneous population of patients due to changes to their central and peripheral nervous systems. Although OAB is frequently associated with female sexual dysfunction (FSD), its real impact on sexual function in women has been evaluated only in a few studies. The first line of treatment for OAB includes behavioural modification and physical therapy, either as monotherapies or in combination. Many patients who have not had success in managing their symptoms with more conservative therapies may decide to resort to third-line treatments for refractory OAB. These treatments include neuromodulation therapies, particularly transvaginal electrical stimulation (TES) and sacral neuromodulation (SN). The aim of this short commentary is to provide an overview of the effectiveness of these treatments and of their impact on quality of life, body image, sexual function, and emotional well-being.
Collapse
|
12
|
Morin F, Akhavizadegan H, Kavanagh A, Moore K. Dysfunctional voiding: Challenges of disease transition from childhood to adulthood. Can Urol Assoc J 2018; 12:S42-S47. [PMID: 29681274 DOI: 10.5489/cuaj.5230] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Fannie Morin
- Division of Urology, Department of Surgery, CHU de Québec, Université Laval, Quebec City, QC
| | - Hamed Akhavizadegan
- International Collaboration on Repair Discoveries (ICORD), Department of Urologic Sciences, University of British Columbia, Vancouver, BC; Canada
| | - Alex Kavanagh
- International Collaboration on Repair Discoveries (ICORD), Department of Urologic Sciences, University of British Columbia, Vancouver, BC; Canada
| | - Katherine Moore
- Division of Urology, Department of Surgery, CHU de Québec, Université Laval, Quebec City, QC
| |
Collapse
|
13
|
Corcos J, Przydacz M, Campeau L, Witten J, Hickling D, Honeine C, Radomski SB, Stothers L, Wagg A. CUA guideline on adult overactive bladder. Can Urol Assoc J 2017; 11:E142-E173. [PMID: 28503229 PMCID: PMC5426936 DOI: 10.5489/cuaj.4586] [Citation(s) in RCA: 80] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Jacques Corcos
- Department of Urology, Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - Mikolaj Przydacz
- Department of Urology, Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - Lysanne Campeau
- Department of Urology, Jewish General Hospital, McGill University, Montreal, QC, Canada
| | | | - Duane Hickling
- Division of Urology, Department of Surgery, The Ottawa Hospital, Ottawa, ON, Canada
| | - Christiane Honeine
- Department of Urology, Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - Sidney B. Radomski
- Division of Urology, Toronto Western Hospital, University of Toronto, University Health Network, Toronto, ON, Canada
| | - Lynn Stothers
- Department of Urological Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Adrian Wagg
- Department of Medicine, University of Alberta, Edmonton, AB, Canada
| |
Collapse
|
14
|
Chu CM, Arya LA, Andy UU. Impact of urinary incontinence on female sexual health in women during midlife. Womens Midlife Health 2015; 1:6. [PMID: 30766693 PMCID: PMC6214215 DOI: 10.1186/s40695-015-0007-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Accepted: 08/07/2015] [Indexed: 11/10/2022] Open
Abstract
Sexual health is important to the self worth, emotional well being, and overall quality of life of women in midlife. However, urinary incontinence, which is prevalent in this population, has a negative impact on sexual function. The purpose of this article is to review the impact of urinary incontinence on female sexual dysfunction and discuss the impact of urinary incontinence treatment on sexual function. We carried out a literature review on the effect of stress urinary incontinence and urgency urinary incontinence on sexual health and physiological response, including coital incontinence, satisfaction, desire, orgasm, frequency, and partner relationships. We examined the literature regarding changes in sexual function related to non-surgical and surgical interventions for incontinence. Overall, though studies are lacking and of poor quality, treatment of incontinence has been shown to improve sexual function. Both pelvic muscle training and midurethral slings have been shown to improve sexual function in those with stress urinary incontinence. In urgency urinary incontinence, evidence indicates improvement in sexual function after treatment with anti-muscarinic medications. Coital incontinence commonly improves with treatment of the underlying incontinence subtype. Although problems related to sexual health are complex and involve both psychological and physical factors, it is important to consider treatment of urinary incontinence as part of management of sexual dysfunction.
Collapse
Affiliation(s)
- Christine M Chu
- Division of Urogynecology, Department of Obstetrics and Gynecology, University of Pennsylvania School of Medicine, 3400 Spruce St., 1000 Courtyard Building, Philadelphia, PA 19104 USA
| | - Lily A Arya
- Division of Urogynecology, Department of Obstetrics and Gynecology, University of Pennsylvania School of Medicine, 3400 Spruce St., 1000 Courtyard Building, Philadelphia, PA 19104 USA
| | - Uduak U Andy
- Division of Urogynecology, Department of Obstetrics and Gynecology, University of Pennsylvania School of Medicine, 3400 Spruce St., 1000 Courtyard Building, Philadelphia, PA 19104 USA
| |
Collapse
|
15
|
Bortolami A, Vanti C, Banchelli F, Guccione AA, Pillastrini P. Relationship Between Female Pelvic Floor Dysfunction and Sexual Dysfunction: An Observational Study. J Sex Med 2015; 12:1233-41. [DOI: 10.1111/jsm.12882] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
|
16
|
Castagna G, Montorsi F, Salonia A. Sexual and bladder comorbidity in women. HANDBOOK OF CLINICAL NEUROLOGY 2015; 130:165-76. [PMID: 26003244 DOI: 10.1016/b978-0-444-63247-0.00010-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Sexual dysfunction in women is defined as disorders of sexual desire, arousal, orgasm, and/or sexual pain, which result in significant personal distress and may have a negative effect on a woman's health and an impact on her quality of life. A comprehensive understanding of the anatomic, neurobiologic, and psychologic mechanisms behind women's sexual function and dysfunction is of paramount importance. This chapter reviews the most frequent comorbid conditions related to urinary tract symptoms (thus including symptoms related to overactive bladder syndrome and urinary incontinence) and sexual dysfunction in women. Likewise, it considers the different disorders from the point of view of daily clinical practice.
Collapse
Affiliation(s)
- Giulia Castagna
- Universitá Vita-Salute San Raffaele, Milan, Italy; Division of Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Francesco Montorsi
- Universitá Vita-Salute San Raffaele, Milan, Italy; Division of Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Andrea Salonia
- Division of Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy; Research Doctorate Program in Urology, Magna Graecia University, Catanzaro, Italy.
| |
Collapse
|
17
|
Aydın S, Arıoğlu Aydın Ç, Batmaz G, Dansuk R. Effect of vaginal electrical stimulation on female sexual functions: a randomized study. J Sex Med 2014; 12:463-9. [PMID: 25470078 DOI: 10.1111/jsm.12788] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
INTRODUCTION Female sexual dysfunction (FSD) is a common problem that may be encountered in the interruption of normal sexual functioning in the sexual response cycle. Women with a pelvic floor disorder who scored low on the Female Sexual Function Index (FSFI) showed an improvement in their sexual life following treatment by vaginal electrical stimulation (VES). AIM The aim of this trial was to evaluate the effectiveness of VES in women with FSD without a predominant pelvic floor disorder or urinary incontinence. METHODS Forty-two women with FSD were randomly allocated to VES and placebo groups. Pelvic floor muscle (PFM) assessment and the FSFI questionnaire were performed at baseline and after the completion of sessions. VES treatment was administered using a vaginal probe. The probe was inserted, and a medium-frequency (50 Hz) alternating current was administered for a duty cycle of 5 seconds on followed by a 5-second rest. MAIN OUTCOMES MEASURES Primary outcome measure was the improvement in FSFI score. PFM assessments were performed according to the PERFECT scheme. RESULTS Total FSFI scores improved significantly in both the VES group and the control group. Results show that in the VES group, there was an improvement in total score and FSFI domains that improved including arousal, desire, orgasm, and satisfaction. Similarly, control group domains that improved were desire, arousal, and orgasm. But there was no significant increase in satisfaction scores in the placebo group. No significant changes in pain or lubrication domains were seen in either group. Power, endurance, fast contractions, and repetitions were significantly improved in the VES group. CONCLUSIONS The lack of significant differences between the placebo and VES groups, except the satisfaction domain, puts into question the effectiveness of electrical stimulation as a monotherapy in treating primary FSD without pelvic floor disorder.
Collapse
Affiliation(s)
- Serdar Aydın
- Department of Obstetric and Gynecology, Bezmialem Vakif University, İstanbul, Turkey
| | | | | | | |
Collapse
|
18
|
|
19
|
Berzuk K. The Pelvic Floor Muscle: the Link Between Bladder, Bowel, and…Sex? A Review of Current Pelvic Therapy Approaches for Diagnosis and Treatment of Sexual Disorders. CURRENT SEXUAL HEALTH REPORTS 2014. [DOI: 10.1007/s11930-014-0025-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
20
|
Pereira H, Menezes J. Impact of urinary incontinence on sexual quality of life in Portuguese adults. INTERNATIONAL JOURNAL OF UROLOGICAL NURSING 2014. [DOI: 10.1111/ijun.12040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
21
|
Schoenfeld M, Fuermetz A, Muenster M, Ennemoser S, von Bodungen V, Friese K, Jundt K. Sexuality in German urogynecological patients and healthy controls: is there a difference with respect to the diagnosis? Eur J Obstet Gynecol Reprod Biol 2013; 170:567-70. [PMID: 23988220 DOI: 10.1016/j.ejogrb.2013.08.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Revised: 07/06/2013] [Accepted: 08/01/2013] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To evaluate sexual function among German urogynecological patients compared to a control group without urogynecological symptoms, using the validated German version of the Australian pelvic floor questionnaire. STUDY DESIGN Retrospective study including 313 women divided into five subgroups: women with stress urinary incontinence (SUI), overactive bladder (OAB), mixed incontinence (MI), pelvic organ prolapse (POP) and healthy controls. The self-administered questionnaire is divided into three domains: bladder, pelvic organ prolapse, and sexual function. It also includes severity, bothersomeness and condition-specific quality of life. Only completely filled out questionnaires were included. The Mann-Whitney U-test was used as a non-parametric test to calculate significances for ordinal data. A p-value <.05 was taken as significant. RESULTS 16/59 (27.1%) women in the control group were not sexually active compared to 19/60 (31.7%) in the SUI group, 51/98 (52.0%) in the mixed-incontinence group, 19/43 (44.2%) in the OAB group, and 24/53 (45.3%) in the prolapse group. Coital incontinence was present significantly more often in women with SUI (15/41, 36.6%) or mixed incontinence (20/44, 45.5%) than among the controls (1/49, 2.1%). Hence, concerning sexuality, women with urogynecological symptoms were all significantly more affected than the healthy controls. CONCLUSION The German version of the Australian pelvic floor questionnaire is a feasible tool to evaluate not only symptoms of urinary incontinence and pelvic organ prolapse but also sexual dysfunction. A substantial proportion of our urogynecological patients suffer immensely from problems with their sexuality, and it is therefore our responsibility as physicians to provide assistance and improve our education in this field.
Collapse
Affiliation(s)
- Mirjam Schoenfeld
- Department of Obstetrics and Gynecology, Ludwig-Maximilians-University Munich, Maistrasse, Germany
| | | | | | | | | | | | | |
Collapse
|
22
|
Abstract
INTRODUCTION Women may expel various kinds of fluids during sexual arousal and at orgasm. Their origins, quantity, compositions, and expulsion mechanisms depend on anatomical and pathophysiological dispositions and the degree of sexual arousal. These are natural sexual responses but may also represent symptoms of urinary incontinence. AIM The study aims to clarify the etiology of fluid leakage at orgasm, distinguish between associated physiological sexual responses, and differentiate these phenomena from symptoms of illness. METHODS A systematic literature review was performed. EMBASE (OvidSP) and Web of Science databases were searched for the articles on various phenomena of fluid expulsions in women during sexual arousal and at orgasm. MAIN OUTCOME MEASURES Articles included focused on female ejaculation and its variations, coital incontinence (CI), and vaginal lubrication. RESULTS Female ejaculation orgasm manifests as either a female ejaculation (FE) of a smaller quantity of whitish secretions from the female prostate or a squirting of a larger amount of diluted and changed urine. Both phenomena may occur simultaneously. The prevalence of FE is 10-54%. CI is divided into penetration and orgasmic forms. The prevalence of CI is 0.2-66%. Penetration incontinence occurs more frequently and is usually caused by stress urinary incontinence (SUI). Urodynamic diagnoses of detrusor overactivity (DOA) and SUI are observed in orgasmic incontinence. CONCLUSIONS Fluid expulsions are not typically a part of female orgasm. FE and squirting are two different physiological components of female sexuality. FE was objectively evidenced only in tens of cases but its reported high prevalence is based mostly on subjective questionnaire research. Pathophysiology of squirting is rarely documented. CI is a pathological sign caused by urethral disorder, DOA, or a combination of both, and requires treatment. An in-depth appreciation of these similar but pathophysiologically distinct phenomena is essential for distinguishing normal, physiological sexual responses from signs of illness.
Collapse
Affiliation(s)
- Zlatko Pastor
- Obstetrics and Gynaecology Department, 2nd Medical Faculty, Teaching Hospital Motol, Charles University, Prague, Czech Republic.
| |
Collapse
|
23
|
Signorello D, Seitz CC, Berner L, Trenti E, Martini T, Galantini A, Lusuardi L, Lodde M, Pycha A. Impact of Sacral Neuromodulation on Female Sexual Function and His Correlation with Clinical Outcome and Quality of Life Indexes: A Monocentric Experience. J Sex Med 2011; 8:1147-55. [DOI: 10.1111/j.1743-6109.2010.02189.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
24
|
Rivalta M, Sighinolfi MC, Micali S, De Stefani S, Torcasio F, Bianchi G. Urinary Incontinence and Sport: First and Preliminary Experience With a Combined Pelvic Floor Rehabilitation Program in Three Female Athletes. Health Care Women Int 2010; 31:435-43. [DOI: 10.1080/07399330903324254] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
25
|
Rivalta M, Sighinolfi MC, Micali S, De Stefani S, Bianchi G. Sexual Function and Quality of Life in Women with Urinary Incontinence Treated by a Complete Pelvic Floor Rehabilitation Program (Biofeedback, Functional Electrical Stimulation, Pelvic Floor Muscles Exercises, and Vaginal Cones). J Sex Med 2010; 7:1200-8. [DOI: 10.1111/j.1743-6109.2009.01676.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
26
|
|
27
|
Pace G, Silvestri V, Gualá L, Vicentini C. Body mass index, urinary incontinence, and female sexual dysfunction. Menopause 2009; 16:1188-92. [DOI: 10.1097/gme.0b013e3181a6b491] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
28
|
Su TH, Lau HH, Huang WC, Chen SS, Lin TY, Hsieh CH, Yeh CY. Short term impact on female sexual function of pelvic floor reconstruction with the Prolift procedure. J Sex Med 2009; 6:3201-7. [PMID: 19627464 DOI: 10.1111/j.1743-6109.2009.01399.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The Prolift system is an effective and safe procedure using mesh reinforcement for vaginal reconstruction of pelvic organ prolapse (POP), but its effect on sexual function is unclear. AIM To evaluate the impact of transvaginal pelvic reconstruction with Prolift on female sexual function at 6 months post-operatively. METHODS Thirty-three sexually active women who underwent Prolift mesh pelvic floor reconstruction for symptomatic POP were evaluated before and 6 months after surgery. Their sexual function was assessed by using the short form of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) before and after surgery. The quality of life was also evaluated with the short forms of the Urogenital Distress Inventory (UDI-6) and the Incontinence Impact Questionnaire (IIQ-7) as a control for efficacy of the procedure. The Pelvic Organ Prolapse Quantification system was used to evaluate the degree of prolapse. MAIN OUTCOME MEASURES PISQ-12 scores at 6 months post-operatively. RESULTS The total PISQ-12 score decreased from 29.5 +/- 9.0 to 19.3 +/- 14.7 (P < 0.001), indicating worsening of sexual function 6 months post-operatively. The behavioral, physical, and partner-related domains of PISQ-12 were each significantly reduced (5.2 +/- 3.7 vs. 2.9 +/- 3.7, P = 0.016; 15.4 +/- 4.7 vs. 10.4 +/- 8.6, P = 0.001; 8.9 +/- 3.8 vs. 6.4 +/- 5.5, P = 0.01, respectively). UDI-6 and IIQ-7 scores were significantly improved at the 6-month follow-up, as was anatomic recovery. Of the 33 subjects, 24 (73%) had worse sexual function 6 months after the procedure. CONCLUSION The Prolift procedure provided an effective anatomic cure of POP, but it had an adverse effect on sexual function at 6 months after surgery.
Collapse
Affiliation(s)
- Tsung-Hsien Su
- Mackay Memorial Hospital-Division of Urogynecology, Department of Obstetrics and Gynecology, Taipei, Taiwan 92, Chung-San North Road, Section 2, Taipei 104, Taiwan.
| | | | | | | | | | | | | |
Collapse
|
29
|
Rivalta M, Sighinolfi MC, De Stefani S, Micali S, Mofferdin A, Grande M, Bianchi G. ORIGINAL RESEARCH—WOMEN'S SEXUAL HEALTH: Biofeedback, Electrical Stimulation, Pelvic Floor Muscle Exercises, and Vaginal Cones: A Combined Rehabilitative Approach for Sexual Dysfunction Associated with Urinary Incontinence. J Sex Med 2009; 6:1674-1677. [DOI: 10.1111/j.1743-6109.2009.01238.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
30
|
When worlds collide: urinary incontinence and female sexuality. Am J Nurs 2009; 109:59-63. [PMID: 19240500 DOI: 10.1097/01.naj.0000346934.20864.79] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
31
|
Serati M, Salvatore S, Uccella S, Nappi RE, Bolis P. Female Urinary Incontinence During Intercourse: A Review on an Understudied Problem for Women's Sexuality. J Sex Med 2009; 6:40-8. [PMID: 19170835 DOI: 10.1111/j.1743-6109.2008.01055.x] [Citation(s) in RCA: 81] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
|
32
|
Yang S, Yang J, Wang K, Huang W. Biologic Correlates of Sexual Function in Women with Stress Urinary Incontinence. J Sex Med 2008; 5:2871-9. [DOI: 10.1111/j.1743-6109.2008.00985.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
33
|
|
34
|
Lombardi G, Mondaini N, Macchiarella A, Cilotti A, Popolo GD. Clinical Female Sexual Outcome after Sacral Neuromodulation Implant for Lower Urinary Tract Symptom (LUTS). J Sex Med 2008; 5:1411-7. [DOI: 10.1111/j.1743-6109.2008.00812.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
35
|
Rosenbaum TY, Owens A. Continuing Medical Education: The Role of Pelvic Floor Physical Therapy in the Treatment of Pelvic and Genital Pain-Related Sexual Dysfunction (CME). J Sex Med 2008; 5:513-23; quiz 524-5. [DOI: 10.1111/j.1743-6109.2007.00761.x] [Citation(s) in RCA: 99] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
36
|
Elzevier HW, Putter H, Delaere KP, Venema PL, à Nijeholt AL, Pelger RC. Female Sexual Function after Surgery for Stress Urinary Incontinence: Transobturator Suburethral Tape vs. Tension-Free Vaginal Tape Obturator. J Sex Med 2008; 5:400-6. [DOI: 10.1111/j.1743-6109.2007.00671.x] [Citation(s) in RCA: 78] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
37
|
Voorham-van der Zalm PJ, Lycklama À Nijeholt GAB, Elzevier HW, Putter H, Pelger RCM. "Diagnostic investigation of the pelvic floor": a helpful tool in the approach in patients with complaints of micturition, defecation, and/or sexual dysfunction. J Sex Med 2008; 5:864-871. [PMID: 18221287 DOI: 10.1111/j.1743-6109.2007.00725.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
INTRODUCTION Pelvic floor dysfunction is recognized to be related to lower urinary tract dysfunction and to lower gastrointestinal symptoms, and is an influential factor in dysfunction and subsequent behavior of the genital system in both men and women. Caregivers should be informed regarding normal pelvic floor function in general and should be able to identify specific aspects of pelvic floor dysfunction in patients with related symptoms. In our hospital, this diagnostic consultation is indicated as Diagnostic Investigation of Pelvic Floor Function (DIPFF). AIM This study looked at pelvic floor dysfunction related to specific complaints. METHODS DIPFF consists of a medical history, a physical examination, including the International Continence Society (ICS) pelvic organ prolapse quantification system in female patients, and a biofeedback registration using a vaginal or anal probe. Based on our experience, we defined an elevated rest tone as greater than 2 microV using intravaginal or intra-anal electromyography. MAIN OUTCOME MEASURES Stratification of patients with a single complaint, a combination of two or three complaints of the micturition, defecation or sexual (all compartments of the pelvic floor) resulted in subgroups of respectively 30, 74, and 133 patients. RESULTS A total of 238 patients with complaints of micturition, defecation, and/or sexual function were included in this study. Electromyographic analysis revealed an elevated rest tone of the pelvic floor in 141 patients. In 184 patients, we found an involuntary relaxation of the pelvic floor. CONCLUSION In our retrospective study, we found that 77.2% of patients who presented to the clinic with urinary, gastro or sexual complaints had measurable pelvic floor dysfunction (69.3% overactive rest tone and 7.9% under active rest tone). In relation to the ICS terminology, there is a need for a well-defined normal vs. elevated rest tone of the pelvic floor.
Collapse
Affiliation(s)
| | | | | | - Hein Putter
- Leiden University Medical Center-Medical Statistics, Leiden, the Netherlands
| | - Rob C M Pelger
- University Medical Center Leiden-Urology, Leiden, the Netherlands
| |
Collapse
|
38
|
Mehta A, Bachmann G. Premenopausal women with sexual dysfunction: the need for a bladder function history. J Sex Med 2007; 5:407-12. [PMID: 18093095 DOI: 10.1111/j.1743-6109.2007.00704.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Despite the high prevalence of both female sexual problems and bladder dysfunction in the premenopausal population, sexual history forms used in primary care offices rarely include questions about the impact of bladder dysfunction on sexual health. AIM To provide a review of the literature that illustrates the relationship between bladder problems and sexual performance of premenopausal women. MAIN OUTCOME MEASURES To objectively support by a review of the literature the need for a complete bladder history in when evaluating premenopausal women with female sexual dysfunction. METHODS Pubmed was searched for all articles (from November 1980 to June 2007) that reported on the effect bladder dysfunction has on premenopausal female sexual function. RESULTS The scant literature available strongly suggested that bladder dysfunction is a contributor to sexual dysfunction and that this medical concern should be considered in all women, regardless of age who present with sexual complaints. CONCLUSION Further studies need to be conducted in order to solidify a direct causal relationship between bladder dysfunction and premenopausal female sexuality. These studies should include a larger sample size, clearly defined types of sexual dysfunction and bladder dysfunction, and appropriate follow-up of patient responses using validated objective and subjective outcome modalities to confirm that the patient responses are factual.
Collapse
Affiliation(s)
- Aasta Mehta
- Women's Health Institute, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | | |
Collapse
|
39
|
Ferenidou F, Kapoteli V, Moisidis K, Koutsogiannis I, Giakoumelos A, Hatzichristou D. Presence of a sexual problem may not affect women's satisfaction from their sexual function. J Sex Med 2007; 5:631-9. [PMID: 17971103 DOI: 10.1111/j.1743-6109.2007.00644.x] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
INTRODUCTION It has been proposed that women's sexual problems/dysfunctions, in the absence of personal and interpersonal distress, may have little clinical importance, as they may not necessarily affect women's sexual satisfaction. However, data are missing to support such interpretation. AIM The objective of the present study was to examine whether the presence of a sexual problem necessary affects women's satisfaction with sexual function. METHOD The study included 164 women who visited a general hospital because of symptoms not related to their sexual function and were asked to complete voluntarily and anonymously demographic data and two questionnaires. MAIN OUTCOME MEASURES Women completed the Female Sexual Function Index (FSFI)--an instrument which evaluates women sexual function--and the Symptom Checklist of Sexual Function-women version (SCSF-w), a screening tool of women's self-perception of sexual function. RESULTS Mean patients' age was 43 +/- 12.6 (18-72) years. According to the FSFI, 48.8% of the participants had a sexual dysfunction. However, based on their self-perception of sexual function (SCSF), 80.5% of the sample declared to be satisfied with their sexual function, despite the fact that 69.5% of them reported at least one sexual problem. Of all women, only 26.2% would like to talk about their sexual problem(s) with a doctor (57.4% of those who are "bothered" by their sexual symptoms). Logistic regression analysis revealed no association between any sexual dysfunction and women's satisfaction from their sexual function. CONCLUSION Despite the presence of sexual problem(s), women may be satisfied with their sexual function, but half of those who are bothered would like to talk about it with their doctor. The presence of a sexual problem or its severity is not a determinant of women's help-seeking behavior. Such data strongly support current definitions of women's sexual dysfunction, where the presence of personal distress has been included as a crucial dimension.
Collapse
Affiliation(s)
- Fotini Ferenidou
- Center for Sexual and Reproductive Health, Aristotle University of Thessaloniki and Papageorgiou General Hospital, Thessaloniki, Greece
| | | | | | | | | | | |
Collapse
|
40
|
Wimpissinger F, Stifter K, Grin W, Stackl W. The Female Prostate Revisited: Perineal Ultrasound and Biochemical Studies of Female Ejaculate. J Sex Med 2007; 4:1388-93; discussion 1393. [PMID: 17634056 DOI: 10.1111/j.1743-6109.2007.00542.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Many speculations have been made on the possible existence of a "female prostate gland" and "female ejaculation." Despite several reports on the subject, controversy still exists around the "female prostate" and whether such a gland might be the source of fluid emitted during orgasm (ejaculation). AIM To investigate the ultrasonographic, biochemical, and endoscopic features in two women who reported actual ejaculations during orgasm. MAIN OUTCOME MEASURES Perineal ultrasound studies, as well as biochemical characteristics of ejaculate and urethroscopy, have been performed in two women. METHODS Two premenopausal women--44 and 45 years of age--who actually reported fluid expulsion (ejaculation) during orgasm have been investigated. Ultrasound imaging, biochemical studies of the ejaculated fluid, and endoscopy of the urethra have been used to identify a prostate in the female. Ejaculated fluid parameters have been compared to voided urine samples. RESULTS On high-definition perineal ultrasound images, a structure was identified consistent with the gland tissue surrounding the entire length of the female urethra. On urethroscopy, one midline opening (duct) was seen just inside the external meatus in the six-o'clock position. Biochemically, the fluid emitted during orgasm showed all the parameters found in prostate plasma in contrast to the values measured in voided urine. CONCLUSIONS Data of the two women presented further underline the concept of the female prostate both as an organ itself and as the source of female ejaculation.
Collapse
|
41
|
Whitmore K, Siegel JF, Kellogg-Spadt S. Interstitial cystitis/painful bladder syndrome as a cause of sexual pain in women: a diagnosis to consider. J Sex Med 2007; 4:720-727. [PMID: 17498107 DOI: 10.1111/j.1743-6109.2007.00497.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Sexual pain, or dyspareunia, is a common symptom among women. Dyspareunia presents in many ways, and arises from a range of causes. Interstitial cystitis/painful bladder syndrome (IC/PBS) is one potential cause that may frequently be overlooked by clinicians. Interstitial cystitis is increasingly recognized as more common than was once thought. However, it can be difficult to identify, as the symptoms of IC/PBS (urinary urgency and frequency, dyspareunia, nocturia, and pelvic pain) overlap with other urogynecologic conditions. AIM This article will review the association between dyspareunia and IC/PBS, and will provide an approach to the diagnosis and treatment of IC/PBS in women with sexual pain. METHODS AND MAIN OUTCOME MEASURES Review of the medical literature and expert medical opinion. RESULTS Many women with IC/PBS experience dyspareunia, often in conjunction with chronic pelvic pain. When IC/PBS is suspected, there are simple measures to aid in the diagnosis of this condition, and treatments are readily available. CONCLUSIONS When a woman presents with the symptoms of urinary urgency and frequency, dyspareunia, nocturia, and/or pelvic pain, IC/PBS should be part of the diagnostic evaluation.
Collapse
|