Prolapse or incontinence: what affects sexual function the most?

Abstract

Introduction and hypothesisPelvic organ prolapse (POP) and stress urinary incontinence (SUI) adversely affect sexual function in women. Comparative studies of the two subgroups are few and results are conflicting. The aim of this study was to compare the effect of POP and SUI on the sexual function of women undergoing surgery for these conditions.MethodsThe study population comprised women with POP or SUI in a tertiary referral hospital in the UK. Women who underwent SUI surgery had no symptoms of POP and had urodynamically proven stress incontinence. Patients with POP had ≥ stage 2 prolapse, without bothersome urinary symptoms. Pre-operative data on sexual function were collected and compared using an electronic pelvic floor assessment questionnaire (ePAQ). The incidence of sexual dysfunction and comparison of symptoms in both groups were calculated using the Mann–Whitney U test.ResultsThree hundred and forty-three women undergoing surgery for either SUI or POP were included. Patients were age-matched, with 184 undergoing SUI surgery (age range 33–77 years) and 159 POP surgery (age range 27–78 years; p = 0.869). The overall impact of POP and SUI was not significantly different in the two subgroups (p = 0.703). However, both patients (73 % vs 36 %; p = 0.00) and partners (50 % vs 24 %; p = 0.00) avoid intercourse significantly more frequently in cases with POP compared with SUI. This did not have a significant impact on quality of life.ConclusionsThe impact of bothersome SUI or POP on sexual function was found to be similar, but patient and partner avoidance in women with POP was greater than those with SUI.

Factors Associated with Sexual Activity for Women with Pelvic Floor Dysfunction - A Cross-Sectional Study

“…II. Jha et al 5 reported that the absence of sexual activity among women with POP was greater than that among women with UI. Moroni et al 19 claimed that, among women with POP, the anatomical features of the prolapse did not appear to interfere with genital body image or with sexual function.…”

“…The demand for evaluation and treatment of these conditions has steadily increased in recent years, with increased life expectancy and efforts to promote quality of life (QoL). 4,5 Sexuality is a fundamental part of human life, and is an important parameter for health and QoL. 6 Thus, the current study sought to identify factors that affect sexual activity in women with PFD, and the impacts of QoL, according to sexual activity status.…”

The impact of genital self-image on sexual function in women with pelvic floor disorders

“…Several studies have found an association between pelvic floor disorders and overall poorer sexual function [7,8] with up to 60% of sexually active women attending urogynecology clinics reporting sexual dysfunction [5]. However, there are conflicting results regarding the different effects of urinary incontinence and pelvic organ prolapse over overall sexual function [6,9].…”

“…As to the different effects of different pelvic floor disorders over components of sexual dysfunction, research has suggested that prolapse is more likely than urinary incontinence to result in sexual inactivity [9,10], especially when bulging of genital organs is presented [8]. Other studies report that urinary incontinence is related to infrequent orgasm [11], low libido, vaginal dryness and dyspareunia [12].…”

Effect of pelvic floor dysfunction on sexual function and quality of life in Chinese women of different ages: An observational study

“…Clinical symptoms of POP include incontinence, constipation, vaginal pressure and sexual dysfunction . POP is a serious health problem, which is associated with quality of life, sexual function and psychological state . UI is divided into several types, and it affects up to approximately 41% of women worldwide .…”