Psycho-relational aspects of urinary incontinence in female sexuality

Abstract

Urinary incontinence (UI) is a very common disorder in women, involving severe consequences on the patients' perception of quality of life and sexuality. The aim of this contribution is to analyze the psycho-relational aspects linked to UI, focusing on sexual activity, self-perception of sexual competence and self-esteem. Urinary incontinence causes feelings of shame and inadequacy as well as low self-esteem; it may affect sexual activity, reducing sexual intercourse frequency. Many authors highlight a strong comorbidity between urinary incontinence and sexual dysfunctions, such as dyspareunia, vaginismus, hypo-active sexual desire, arousal and orgasm disorders. Literature analysis shows that changes in sexual activity are influenced not only by urinary incontinence symptoms but also by the disorder self-perception, by previous sexuality, menopause, social status and the partner's attitude. The etiological study of urinary incontinence shows that several different factors play a role in this disorder. Therefore, an integrated therapeutic approach is suggested, considering, besides the organic issues, the experience and feelings of patients as well as the consequences on their sexual and social life.