Women Who Suffer From Lower Urinary Tract Symptoms, Urinary Incontinence More Likely to Experience Sexual Dysfunction
Lower urinary tract symptoms (LUTS) in the form of stress urinary incontinence (SUI) and overactive bladder (OAB), with or without urinary incontinence, is an exceedingly common problem among American women, and causes tremendous economic and social burden for those suffering from this problem. Various epidemiologic studies have demonstrated diminished quality of life scores, increased social embarrassment, altered sleep patterns, and impaired mental health in women with all forms of urinary incontinence. However, the impact of LUTS on female sexual dysfunction remains poorly characterized.
For this study, we performed a retrospective analysis of women seen in our female urology clinic over a 3 year time period, specifically comparing the results from a self-administered questionnaire, the Female Sexual Function Index (FSFI) in women with different types of LUTS. We categorized women based upon clinical history and physical examination as well as using urodynamic data.
We found that women with OAB symptoms with urinary incontinence had the worst scores on the FSFI indicating worse sexual function. Women with SUI also experienced sexual dysfunction, but not to the degree that those with OAB symptoms with urinary incontinence did. Those women without urinary incontinence, but with OAB symptoms, had the highest degree of sexual function in our patient population. This clinical data was supported by the urodynamic data as women with detrusor overactivity, with associated incontinence, without SUI had the lowest FSFI scores. Women with SUI on urodynamic study also were affected to a slightly lesser degree. However, women with normal urodynamic studies had the highest degree of sexual function as measured by the FSFI.
Although this is a retrospective study, we feel that the data we have gathered provides new insight into the role of LUTS and its relationship to female sexual dysfunction. From both the clinical history and the urodynamic data, we see that the sexual life of women with OAB symptoms with urinary incontinence is affected to a high degree. Further studies are needed to attempt to elucidate the reason for this finding and to evaluate the various treatment options for LUTS and the potential for improvement in female sexual dysfunction with treatment.
J Sex Med. 2008 Mar 19. (Epub)