Bowel function, sexual function, and symptoms of pelvic organ prolapse in women with and without urinary incontinence

Abstract

Aims Bowel symptoms, pelvic organ prolapse, and sexual dysfunction are common, but their frequency among women with lower urinary tract symptoms (LUTS) has not been well described. Our aims were to describe pelvic floor symptoms among women with and without urinary incontinence (UI) and among subtypes of UI. Methods Women with LUTS seeking care at six U.S. tertiary care centers enrolled in prospective cohort study were studied. At baseline, participants completed the Pelvic Floor Distress Inventory (PFDI-20), Pelvic Organ Prolapse/Incontinence Sexual Questionnaire (PISQ-IR), and PROMIS GI Diarrhea, Constipation, and Fecal Incontinence Scales. Results Mean age among the 510 women was 56.4 ± 14.4 years. Women who reported UI (n=420) had more diarrhea and constipation symptoms (mean scores 49.5 vs 46.2 [p=0.01] and 51.9 vs 48.4 [p<0.01], respectively) at baseline. Among sexually active women, mean PISQ-IR subscale scores were lower among those with UI (condition specific: 89.8 vs 96.7, p<0.01; condition impact: 79.8 vs 92.5, p<0.01). Women with mixed urinary incontinence (MUI) (n=240) reported more prolapse symptoms, fecal incontinence, and worse sexual function compared to those with stress urinary incontinence (SUI) and urgency urinary incontinence (UUI). Conclusions Women presenting with LUTS with UI reported significantly worse constipation, diarrhea, fecal incontinence, and sexual function compared to women without UI. In women with UI, sexual function and pelvic organ prolapse (POP) symptoms were worse in those with MUI compared to SUI and UUI.

Musculoskeletal Pelvic Pain and Sexual Function in the First Year After Childbirth

“…Having three examiners may be viewed as a limitation; however, the three examiners trained together before the study began, which ensured consistency in their examination procedures, and the examiners' combined experience with women with pelvic pain exceeded 30 years. In addition, we did not assess other pelvic floor symptoms, such as incontinence or prolapse, which are common in women after childbirth and have been described as affecting sexual function (Cameron et al, 2018).…”

Assessment of the urogynaecology patient in primary care and when to refer

“…Treatment is directed at the predominant symptom. Sexual function – POP is associated with a higher-than background level of sexual dysfunction. 11 Asking screening questions for sexual dysfunction will allow an assessment of the impact of the POP symptoms and will open a conversation about patient goals. Relevant life-style factors – a patient’s occupation may be relevant to exacerbation of the prolapse or the risk of recurrence after treatment.…”

“…Sexual function – POP is associated with a higher-than background level of sexual dysfunction. 11 Asking screening questions for sexual dysfunction will allow an assessment of the impact of the POP symptoms and will open a conversation about patient goals.…”

Systematic review of lower urinary tract symptoms occurring with pelvic organ prolapse

“…Common varieties of UI are UUI, stress UI (SUI) and mixed UI. Mixed UI is by far the most prevalent, with 57% of incontinent women having this type of UI [3], which is both UUI and SUI occurring together [3]. Unfortunately, this variety of UI also is reported by patients to be more bothersome that pure SUI or UUI [3].…”