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.
Highlights
Introduction and hypothesisPelvic organ prolapse (POP) and stress urinary incontinence (SUI) adversely affect sexual function in women
On comparison of the overall incidence of interference of sexual activity due to POP and SUI symptoms, the incidence was found to be higher in the POP group (n=113;7 1 %) compared with the SUI group (n=98; 53 %)
The mean electronic pelvic floor assessment questionnaire (ePAQ) scores were similar for POP (1.56±1.05) and SUI (1.62±1.07) and did not reach any statistical significance (p= 0.703)
Summary
Pelvic 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. Pelvic organ prolapse (POP) and stress urinary incontinence (SUI) are disorders of the pelvic floor that affect about a third of community dwelling women with a significant impact on a woman’s quality of life [1, 2]. Sexual problems commonly described in women with POP or SUI include disorders of desire, arousal, orgasm and dyspareunia. A community-based survey found no difference between sexual activity and satisfaction compared with women without pelvic floor dysfunction [6]. Some studies report no difference in the sexual function in women with prolapse or incontinence [7]; others report that prolapse is more likely to affect sexual relations than incontinence [8, 9], whereas some studies found that women with urinary
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