Introduction Female sexual function contains four major subtypes of desire, arousal, orgasm, and pain. Few studies used validated instruments to determine the dysfunction in these areas and assess their risk factors. Aim To assess the prevalence of and risk factors for individual components of sexual difficulty in women. Methods A self-administered questionnaire containing the Female Sexual Function Index (FSFI) was given to 2,159 woman employees of two hospitals to assess their sexual function and its correlates. Main Outcome Measures The associations between female sexual difficulty in individual domains defined by the FSFI domain scores and potential risk factors assessed by simple questions. Results Among the 1,580 respondents, 930 women’s data were eligible for analysis with a mean age of 36.1 years (range 20–67). Of them, 43.8% had sexual difficulty in one or more domains, including low desire in 31.3%; low arousal, 18.2%; low lubrication, 4.8%; low orgasmic function, 10.4%; low satisfaction, 7.3%; and sexual pain, 10.5%. Compared with the younger women (20–49 years), the oldest age group (50–67 years) had a significantly higher prevalence in low desire, low arousal, and low lubrication, but not in the other domains. Based on multivariate logistic regression analyses, poor relationship with the partner and perception of partner’s sexual dysfunction were major risk factors for low desire, low arousal, low orgasmic function, and low satisfaction. Age and urge urinary incontinence were associated with low lubrication and sexual pain. Most comorbidities were not related to these difficulties, except diabetes being related to low desire. Conclusions Relationship factors had substantial impact on female sexual function in desire, arousal, orgasm, and satisfaction. On the other hand, women’s lubrication problem and sexual pain were related predominantly with biological factors. These are initial results and future research is needed to confirm them.

Introduction There are limited data concerning the relationship between the sexual functioning of each partner in a heterosexual couple. Aim This cross-sectional study was to investigate the association between female sexual function and the male partners' erectile function. Methods Two self-administered questionnaires were used, one distributed to 2,159 female employees of two hospitals in Southern Taiwan and the other to their male partners, if available, to assess sexual function in each partner of the couple. Outcome Measure Female sexual function and male erectile function were assessed by the Female Sexual Function Index (FSFI) and by the International Index of Erectile Function (IIEF), respectively. Results Among the 1,580 female and 779 male respondents, 632 sexually active couples were eligible for the analysis with mean ages of 36.9 years (range 21–67) and 39.5 years (range 18–80) for the women and men, respectively. After adjustment for female age group, nearly all the FSFI and IIEF domain scores correlated significantly to a slight to moderate degree. On the basis of the FSFI and IIEF scores, 42.9% (255/594) of the women reported sexual difficulty, and 15.0% (96/632) of the men reported mild to moderate erectile dysfunction (ED). After adjustment for female age group, the female partners of men with ED had significantly lower total and domain scores of the FSFI than those of men without ED, with effect sizes of ηp2 = 0.02–0.08. After further adjustment for other risk factors, ED of the male partner was still a significant risk factor for female sexual difficulty as well as for sexual difficulty in the aspects of arousal, orgasm, sexual satisfaction, and sexual pain (odds ratio = 2.5–3.3). Conclusions Significant correlations between female sexual functioning and male erectile function were identified.

Abbreviations & AcronymsObjectives: To investigate the association between urinary incontinence and female sexual function in a non-clinical population. Methods: A self-administered questionnaire was distributed to 2159 female employees of two hospitals. Results: Of the 883 sexually active participants, pure stress urinary incontinence was reported in 18.3%, pure urge urinary incontinence in 6.8%, mixed urinary incontinence in 15.1% and no urinary incontinence in 59.8%. The prevalence of female sexual difficulty, defined by the Female Sexual Function Index total score ≤26.55, was 52.0%, 56.1%, 54.3% and 42.2%, respectively (P < 0.05). After adjustment of age, menstrual status, length of marriage, having children and relationship with the partner, all types of urinary incontinence showed a significant association with female sexual difficulty with an odds ratio of 1.6-1.8. Taking into consideration the individual domains, pure urge urinary incontinence was a risk factor for decreased sexual lubrication and more sexual pain, and mixed urinary incontinence was a risk factor for less sexual satisfaction, whereas pure stress urinary incontinence was not related to a difficulty in individual domains. Conclusions: Stress urinary incontinence and urge urinary incontinence are associated with general impairment of female sexual function to a mild degree. Only urge urinary incontinence is related to sexual difficulty in specific domains including sexual lubrication and sexual pain.

a b s t r a c tUreteral avulsion is an uncommon yet severe complication of ureteroscopy. Among 8336 patients who received ureteroscopic procedures in our hospital from December 2001 to December 2011, we encountered two cases of ureteral avulsion. The first of these experienced disruption at the ureteropelvic junction due to extraction of the tubular ureter from the urethra, which was corrected by immediate open surgery to reposition and anastomose the ureter. The second patient sustained a proximal ureteral disruption following retrieval of the ureteroscope, which was wedged in the narrow lumen of the proximal ureter, and led to simultaneous extraction of the distal ureter. Immediate surgical intervention was performed to maintain ureteral continuity. Mild hydronephrosis was observed in kidneys that were ipsilateral to the ureteral avulsion in both patients. However, no physical discomfort or loss of renal function was indicated after 12 months.