Abstract
The aim of this cross-sectional study was to determine the cutoff scores for sexual dysfunction in disease-specific Pelvic Organ Prolapse/Incontinence Sexual Questionnaire—IUGA Revised (PISQ-IR) for women with pelvic floor disorders (PFD). Medical history and urogynecological data of 521 women with PFD were collected. The subjects provided information about their sexual activity and completed Female Sexual Function Index (FSFI) and PISQ-IR questionnaires. Sexually active (SA) women were further analyzed and categorized using their FSFI scores: <26.55—sexual dysfunction, >26.55—no sexual dysfunction. Receiver operating characteristics (ROC) curve tested how well PISQ-IR allowed to discriminate between patients with and without sexual disorders. Area under curve (AUC) was calculated to measure the PISQ-IR Summary Score efficiency in the prediction. The cutoff values which minimalize (1-specifity) and maximize sensitivity were selected. In the analyzed cohort, 250 (48%) women were SA and a total of 226 SA were recruited for the study: 143 (63.3%) with <26.55 FSFI and 83 (36.7%) with >26.55 FSFI (response rate: 90.4%). Using ROC curve analysis, PISQ-IR Summary Score of 2.68 was determined to be the optimal cutoff for distinguishing between dysfunctional and nondysfunctional women (AUC = 0.85), allowing to diagnose sexual dysfunction in SA women with PFD, with 90% sensitivity and 71% specificity.
Highlights
Pelvic floor disorders (PFD) include urinary incontinence (UI), pelvic organ prolapse (POP), and fecal incontinence
53 (23.4%) subjects were diagnosed with UI, 88 (38.9%) with POP, 84 (37.2%) with both POP and UI, and 10.2% with fecal incontinence (FI)
After dichotomizing patients according to their Female Sexual Function Index (FSFI) results, we received two groups: 143 (63.3%) women with 26.55 FSFI
Summary
Pelvic floor disorders (PFD) include urinary incontinence (UI), pelvic organ prolapse (POP), and fecal incontinence. One-fourth of adult women in the United States (U.S.) report at least one PFD, and the prevalence significantly increases with age, from 31.6% between the ages of 50–59, up to 52.7%. In light of the fact that female life expectancy in 2016 was reported to be 80.8 years in Europe, 83.2 in the United Kingdom, and 81.0 in the U.S (World Health Organization), PFD constitute a widespread public health burden and may have a considerable impact on the quality of patient life and functioning, in terms of daily activities, and significantly deteriorated sexual function (SF) [2]. According to Li-Yun-Fong et al, the percentage of sexually active (SA) women among those with PFD was 59% [3].
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