Biofeedback, Electrical Stimulation, Pelvic Floor Muscle Exercises, and Vaginal Cones: A Combined Rehabilitative Approach for Sexual Dysfunction Associated with Urinary Incontinence

Abstract

Introduction Urinary incontinence (UI) is often associated with sexual dysfunction. We present our preliminary experience with a combined rehabilitative approach consisting of biofeedback, functional electrical stimulation, pelvic floor muscle exercises, and vaginal cones. Aim The potential impact of such practice on UI and sexual function was analyzed in our case series and discussed. Main Outcome Measures and Methods We evaluated three women affected by UI and sexual dysfunction. The patients underwent combined pelvic floor rehabilitation (PFR), kept voiding diaries, and filled out the Female Sexual Function Index (FSFI questionnaire) before and after the completion of PFR. We evaluated each domain score, including desire, arousal, lubrication, orgasm, satisfaction, and pain. Results After the combined rehabilitation program, none of them had UI requiring pad use or referred urine leakage during sexual activity, including intercourse. Before PFR, FSFI score ranged from 16 to 21; after treatment, the FSFI score ranged from 22.1 to 29.3. There was an improvement in patients regarding desire, arousal, lubrication, orgasm, satisfaction, and pain. Conclusions A complete rehabilitation can provide a beneficial effect on sexual function. A larger trial, on a more extended female population, is currently in progress, in order to confirm our findings. The effectiveness of a complete PFR scheme, together with the lack of side effects, makes it a suitable approach to sexual dysfunction that is associated with UI.

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“…Urinary incontinence can significantly affect the quality of life of women, resulting in social avoidance and limiting behaviors 1 . Recent studies of women with urinary incontinence have focused on sexuality issues and sexual function in particular 2,3 . Women with urinary incontinence have reported urgency, frequency, and urinary leakage during sexual activity 3,4 .…”

Effect of Vaginal Electrical Stimulation on Female Sexual Functions: A Randomized Study

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Chinese women's experiences of stress incontinence: a descriptive qualitative study

“…Women who did not adhere to exercise tended to keep incontinence as a secret from their husbands to avoid negative reactions. Reluctance to discuss problems with their sexual partners was also reported in UK, USA and Austria reflecting a similar taboo associated with this problem thus impacted on their sexual relationships (LeCroy, 2006; Rivalta et al ., 2009; Ternent et al ., 2009).…”