Overactive Bladder Syndrome Treatments and Their Effect on Female Sexual Function: A Review

Abstract

Introduction: Overactive bladder (OAB), the most common subtype of urinary incontinence, has a heavy price on quality of life, especially on sexual life. Unfortunately, most women rarely voice the worsening of sexual function, especially those who already suffer from OAB symptoms. It has been demonstrated that patients who suffer from OAB score lower on Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire and Female Sexual Function Index scores, meaning that their sexual function is debilitated. Therapies for OAB begin with traditional pelvic floor physiotherapy, advance to anticholinergic drugs, and become more invasive with intravesical injections of onabotulinumtoxinA (commonly known as Botox). Last, for patients resistant to conservative therapies, sacral neuromodulation is the treatment of choice. Methods: This article reviews the current literature that sheds light on the above 4 treatments and their effect on sexual function. This topic is of great importance because of the under-reporting of sexual dysfunction in women who suffer from OAB, in hopes of raising awareness of sexual function for clinicians treating patients with OAB. Results: This review found that the aforementioned 4 treatments for OAB (physiotherapy, anticholinergic drugs, intravesical injections of onabotulinumtoxinA, and sacral neuromodulation) do not have a detrimental affect on sexual function. On the contrary, the little data that do exist show that sexual function increases after these therapies are completed in women with OAB. Conclusion: This review concludes with a positive outlook: physicians are helping women with OAB syndrome to improve their sexual function. However, not enough data exist, partially due to under-reporting of diminished sexual function.

The impact of pharmacotherapy on sexual function in female patients being treated for idiopathic overactive bladder: a systematic review

“…published a systematic review on sexual function outcomes concerning pelvic floor muscle training, pharmacotherapy, intravesical Botulin toxin injections and neuromodulation [ 81 ]. Although this is a good summary, the major limitations of this review include that it is not comprehensive (only one database was utilised), there was no assessment of bias or comment on the quality of studies included being made available [ 81 ]. This review, in contrast, focussed on pharmacotherapy and as such could follow more closely the requirements for a systematic review as proposed and guided by the AMSTAR 2 appraisal tool [ 23 ].…”

“…Levy G, et al published a systematic review on sexual function outcomes concerning pelvic floor muscle training, pharmacotherapy, intravesical Botulin toxin injections and neuromodulation [81]. Although this is a good summary, the major limitations of this review include that it is not comprehensive (only one database was utilised), there was no assessment of bias or comment on the quality of studies included being made available [81]. This review, in contrast, focussed on pharmacotherapy and as such could follow more closely the requirements for a systematic review as proposed and guided by the AMSTAR 2 appraisal tool [23].…”

Female Sexual Dysfunctions and Urogynecological Complaints: A Narrative Review

“…Traditional pelvic floor physical therapy, anticholinergic medications, and onabotulinumtoxinA (commonly known as Botox) intravesical injections are the first line of treatment for OAB. Last but not least, sacral neuromodulation is the preferred treatment for individuals who have rejected conventional treatments [ 109 ].…”

Efficacy of non‐pharmacological interventions in females with overactive bladder: A systematic review and network meta‐analysis

“…These bothersome symptoms also contribute to a series of negative consequences on individuals, such as anxiety, sexual function disability and lower work productivity (Corcos et al, 2017). As is reported, 26.4% and 16.9% of females suffer from OAB in China mainland and USA, respectively (Chuang et al, 2019;Levy & Lowenstein, 2020). Owing to OAB being significantly correlated with quality of life, the risk and benefits of any therapy should be weighed carefully.Currently, the available options of pharmacological and non-pharmacological interventions have been used to alleviate…”