Psychosexological correlates of 372 women with vulvodynia, overactive pelvic floor, postcoital cystitis, and interstitial cystitis

BACKGROUND

Among the plethora of urogynecological conditions possibly affecting women, some of them, less explored, have significant impacts on sexological and psychological health, with a mutual influence.

AIM

The aim of this study was to investigate the sexological and psychological correlates of four urogynecological pathologies in a sample of women of childbearing age: overactive pelvic floor, vulvodynia, postcoital cystitis, and interstitial cystitis. Women cured of these conditions were also included, to assess the same aspects after the remission of physical symptoms.

METHODS

We recruited 372 women with an average age of 33.5 years through an online platform shared by a popular forum for women with urogynecological pathologies between March and May 2021. The participants filled out a socio-anamnestic questionnaire and a set of psychometric tests.

OUTCOMES

Participant data were collected by use of the Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, Toronto Alexithymia Scale-20, Female Sexual Function Index, and Orgasmometer-F, and the SPSS (Statistical Package for Social Sciences) v.26 was used for data analysis.

RESULTS

Overactive pelvic floor was reported by 66.4% of the women, vulvodynia by 55%, postcoital cystitis by 58.8%, and interstitial cystitis by 8.3%, and these conditions were often comorbid with each other, with 9.4% and 7% of women reporting having suffered psychological and sexual abuse, respectively. The presence of past abuse was correlated with overactive pelvic floor (P < .05), vulvodynia (P < .01), and major depression (P < .01). Significantly more depression occurred in women with vulvodynia than in the other subgroups (P < .05), except for women with only an overactive pelvic floor. There was no difference between the subgroups in the occurrence of alexithymia, sexual function, and orgasm (P < .05). Interestingly, the prevalence of sexual dysfunction increased in cured women.

CLINICAL IMPLICATIONS

The lack of significant differences, except for depression, between the pathological subgroups suggests a similar clinical and psychological relevance of the four pathologies studied. The persistence of sexual dysfunctions in cured women may be related to a residual dysfunctional relational modality with the partner.

STRENGTHS AND LIMITATIONS

The evaluation of both psychological and sexological variables in a group of less-explored urogynecological conditions represents a strength of this study, while a lack of a face-to-face assessment could represent a limitation.

CONCLUSION

The results of the present study should promote psychosexological interventions in women with these diseases, both during the pathological state and after remission.

[Assessment of sexual function and quality of life in women with postcoital cystitis]

INTRODUCTION

According to the literature, 20-50% of women will experience urinary tract infection (UTI) in their lifetime, and in 10-30% of cases, cystitis will recur. Despite the high prevalence of recurrent UTI, there are lack of studies dedicated to its impact on the quality of life, and the influence of postcoital cystitis on the quality of life and sexual function has not been previously evaluated.

AIM

To assess the quality of life and sexual function in patients with recurrent postcoital cystitis before and after transposition of the urethra.

MATERIAL AND METHODS

Women suffering from recurrent postcoital cystitis, who underwent urethral transposition from 2019 to 2021 were included the study. The SF-12v2 questionnaire was used to assess quality of life, while sexual function was evaluated using Female Sexual Function Index [FSFI]. Questionnaires were filled out by 70 patients, before and after surgery.

RESULTS

All domains of the quality of life were significantly different in the pre- and postoperative period. More pronounced changes were found in the mental health-related quality of life. In addition, there were significant differences in each domain of FSFI and the overall score postoperatively compared to baseline.

CONCLUSION

Our study reports a high prevalence of sexual dysfunction among women with recurrent postcoital cystitis as well as a reduced quality of life. This work shows the social significance of the problem, as well as the high rehabilitation potential of urethral transposition.