Biologic correlates of sexual function in women with stress urinary incontinence

INTRODUCTION: Stress urinary incontinence (SUI) has a great impact on the quality of life and sexual function. We hypothesized that specific risk factors for SUI may be correlated with reduced sexual function in women with SUI.

AIMS: To explore significant associations between the risk factors for SUI and female sexual function.

METHODS: Women with SUI (N=223) were surveyed about their sexual function. Demographic data and clinical findings on pelvic examination and the 1-hour pad test were recorded. Sexually active respondents completed the short form of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12).

MAIN OUTCOME MEASURE: PISQ-12 and the correlation of the risk factors for SUI with PISQ-12 scores.

RESULTS: Of the 223 subjects, 68 (30%) reported no sexual activity for 6 months or more prior to the interview and did not respond to the PISQ-12. In comparison with the 155 (70%) of women who were sexually active, sexually inactive respondents were older and more likely to be postmenopausal and had a higher parity and more severe prolapse (all P<0.01). Among those completing the PISQ-12 questionnaire, the same factors (age, parity, severity of prolapse, menopausal status) were significantly associated with lower PISQ-12 scores. The scores were not correlated with body mass index, delivery mode, genital hiatus length, and total vaginal length by the short form of the Pelvic Organ Prolapse Quantification (POP-Q) system, or estrogen therapy. Lower points Ba and C of the POP-Q system were associated with lower PISQ-12 scores (r= -0.200, P=0.026; r= -0.191, P=0.035, respectively). Multivariate analysis identified parity as the only factor independently predictive of sexual dysfunction (r= -0.225, P=0.013).

CONCLUSIONS: Anatomic and biologic pathology does not satisfactorily predict the level of sexual functioning in women with SUI.