Abstract
BackgroundCoital incontinence is an under-reported disorder among women with urinary incontinence. Women seldom voluntarily report this condition, and as such, related data remains limited and is at times conflicting.Aims and objectivesTo investigate the incidence and quality of life in women with coital incontinence and to determine associated predictors.MethodsThis observational study involved 505 sexually active women attending the urogynecologic clinic for symptomatic urinary incontinence at a tertiary medical center. All of the patients were consulted about the experience of coital incontinence and completed evaluations including urodynamics, and valid questionnaires including the short form of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire, the Urogenital Distress Inventory and the Incontinence Impact Questionnaire.ResultsOf these women, 281 (56%) had coital incontinence, while 224 (44%) did not. Among women with coital incontinence, 181 (64%) had urodynamic-proven stress incontinence, 29 (10%) had mixed incontinence, and 15 (5%) had detrusor overactivity. Only 25 (9%) sought consultation for this disorder before direct questioning. Fifty percent (84/281) of the women rarely or sometimes had incontinence during coitus, while 33% (92/281) often had incontinence, and 17% (48/281) always had incontinence. The frequency of coital incontinence was not different regarding the types of incontinence (p = 0.153). Women with mixed incontinence had the worst sexual quality of life and incontinence-related symptom distress. Based on univariate analysis, higher body mass index (OR 2.47, p = 0.027), and lower maximal urethral closure pressure (≤ 30 cmH2O) (OR 4.56, p = 0.007) were possible predictors for coital incontinence. Multivariate analysis showed lower MUCP was independently significant predictors (OR3.93, p = 0.042)ConclusionsThe prevalence of coital intercourse in urinary incontinence women was high. Coital incontinence in these women was associated with abnormal urodynamic diagnosis and urethral dysfunction.
Highlights
Coital incontinence is defined as “complaint of involuntary loss of urine during coitus” according to the International Urogynecological Association and the International Continence Society in 2010 [1]
All of the patients were consulted about the experience of coital incontinence and completed evaluations including urodynamics, and valid questionnaires including the short form of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire, the Urogenital Distress Inventory and the Incontinence Impact Questionnaire
The frequency of coital incontinence was not different regarding the types of incontinence (p = 0.153)
Summary
Coital incontinence is defined as “complaint of involuntary loss of urine during coitus” according to the International Urogynecological Association and the International Continence Society in 2010 [1]. Coital incontinence is a common but under-reported symptom that adversely affects sexually-active women. A literature review by Serati et al searched related articles from 1970 to 2008 and reported the incidence of coital incontinence ranged between 10–27% [2]. Urinary incontinence during coitus may be an embarrassing problem that may lead to reduced sexual desire, reduced ability to achieve an orgasm, and may even be harmful to a relationship, this issue is difficult to understand and research [5]. One reason may be that it would appear that women very seldom voluntarily consult on the issue of coital incontinence unless they are asked directly by physicians or asked to complete related questionnaires [6]. Women seldom voluntarily report this condition, and as such, related data remains limited and is at times conflicting
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