Coital Urinary Incontinence Research Articles

Does Sexual Intercourse Position Have a Role in Occurrence of Coital Urinary Incontinence?

This study was aimed at investigating the hypothesis that sexual intercourse positions may have an impact on the occurrence of coital urinary incontinence (CUI) in women. This case-control observational study enrolled 360 married, heterosexual, sexually active female participants with CUI. Each patient was evaluated using medical and sexual histories, questionnaires, physical examinations, and laboratory tests, including urodynamics. Participants were asked whether or not their intercourse positions had an impact on the occurrence of their CUI. Patients with intercourse position-dependent CUI were included in group 1, and those independent of it were allocatedto group 2. The clinic and laboratory findings of the patient groups were compared. The patients' mean age was 47.24 ± 0.57years. Of these women, 28.9% (n = 104) were in group 1, and 71.1% (n = 256) were in group 2. Group 1 had a lower mean age, body mass index, Charlson comorbidity index, number of urinary incontinence episodes, severity of CUI and incontinence, and pad weight than group 2 (p < 0.05). The rates of detrusor overactivity and penetration type of CUI were higher in group 1 than in group 2 (p < 0.0009, p = 0.009 respectively). According to logistic regression analysis, the likelihood of sexual position-related CUI was 3.5 times higher in women with detrusor overactivity. In certain patients, intercourse position is associated with the occurrence of CUI. This condition seems to be related to detrusor overactivity and is inversely associated with incontinence severity. However, further studies are necessary to explain this phenomenon.

Linguistic translation and validation of the Arabic version of International Female Coital Incontinence Questionnaire (IFCI-Q)

ABSTRACT Objectives Aim of the study was to translate the International Female Coital Incontinence Questionnaire (IFCI-Q) into Arabic (Egyptian) and validate it into among Egyptian population complaining of coital urinary incontinence (CI). Methods Original questionnaire has been translated and back-translated by an expert panel, to produce the Arabic version. A pilot study was performed to make sure the questionnaire was understandable. Sixty patients included in the study were divided into two groups: Group A comprised patients with CI, and Group B comprised females who attended the urology clinic for other complaints, without CI. Reliability of the Arabic IFCI-Q was evaluated for internal consistency using Cronbach alpha coefficient. Test–retest reliability was determined using the Weighted Cohen’s k-test. Discrimination validity was evaluated by comparing scores of patients with those of healthy females not complaining of CI using Mann–Whitney test. Results 83.3% of women of both groups (mean age: 43.1 ± 10.6 yrs [Group A], 38.9 ± 8 [Group B] yrs) reported OAB symptoms, 73.3% had stress urinary incontinence and 46.7% reported mixed urinary incontinence. Regarding Group A, 10 patients had CI during penetration, 12 during orgasm and 8 had both forms of CI. The comparison of the responses between Group A and Group B demonstrated a statistically difference (p < 0.00). The content validity was assessed by a panel of expert functional urologists. The Cronbach’s alpha coefficients for the total score were high (0.9–1), indicating high internal consistency. The difference between the two groups revealed an internal consistency of IFCI-Q of 0.563–0.851. The test–retest procedure revealed that the k-values of each item are very good. Conclusions The Arabic version will allow utilizing this tool in a large population of Arabic-speaking countries, with different ethnic and demographic backgrounds.

Quality of Life, Psychological Wellbeing, and Sexuality in Women with Urinary Incontinence-Where Are We Now: A Narrative Review.

Urinary incontinence (UI) is a very common condition, negatively affecting social, occupational, domestic, and psychophysical wellbeing. In particular, a peculiar and detrimental effect of UI has been described concerning sexual function. However, the impact of UI on quality of life is not fully understood yet, and further investigation into this issue is warranted. With this narrative review, we aimed to report the current evidence from recent literature regarding the quality of life and psychological wellbeing in patients with urinary incontinence, with a special focus on sexual function and its evolution after UI treatment. There is strong evidence that urinary incontinence—in its different forms, including stress urinary incontinence, urge urinary incontinence, mixed urinary incontinence, and coital urinary incontinence—negatively affects female sexual function. Treatments aimed to cure urinary incontinence—including pelvic floor muscles training, medications, and surgery—seem to improve quality of life by recovering, at least in part, sexual function. In conclusion, there is a substantial association between involuntary urinary loss and sex life quality. However, few studies are available and more evidence is needed before consistent conclusions can be made.

Profile of women with pelvic organ prolapse at the University Hospital of the West Indies risk factors and presentation

POP affected 40% of participants in the WHI trial. Risk factors include parity, vaginal delivery, large babies, advancing age, obesity, hysterectomy and lifting. Data suggest African-American women have a lower prevalence of symptomatic POP than other racial groups. Literature review did not show a study of risk factors and symptoms in a black population. Cross-sectional study of women with POP attending urogynaecology clinic at the UHWI from May to October 2013, using an interviewer administered questionnaire was performed and analysed using SPSS version 19 program (SPSS Inc., Chicago, IL). One hundred and eight participants were included: 94.7% postmenopausal (mean 65.08 years) and 94.5% parous (mean 4). Risk factors included obesity (mean BMI 28.82 kg/m2), hysterectomy (28.7%), heavy lifting (51.9%) and chronic cough (13.9%). Symptoms included stress incontinence (40.7%), stranguria (16.7%), faecal incontinence (13.9%), constipation (31.5%), coital urinary and faecal incontinence (6.3%, 12.6%). We concluded risk factors for POP in this population correlates with other studies. Stress urinary incontinence and constipation most frequently reported symptoms in this population. Impact Statement What is already known on this subject? Pelvic organ prolapse (POP) is a common condition with multifactorial aetiology. As seen in systematic reviews (Vergeldt TFM, Weemhoff M, IntHout J, Kluivers KB. 2015. Risk factors for pelvic organ prolapse and its recurrence: a systematic review. International Urogynecology Journal 26(11):1559–1573). Study shows white women appeared to have more overall symptoms both from prolapse, as well as urinary symptoms, as compared with black women (Ford AT, Eto CU, Smith M, Northington GM. 2019. Racial differences in pelvic organ prolapse symptoms among women undergoing pelvic reconstructive surgery for prolapse. Female Pelvic Medicine & Reconstructive Surgery 25:130–133). What do the result s of this study add? The result highlights the fact that Black women are exposed to similar risk factors and have similar symptoms to other racial groups for POP. What are the implications of these findings for clinical practice and/or further research? These findings can be used to educate women with risk factors about the possibility of developing symptomatic POP. Further research is needed to ascertain the prevalence of POP and to assess knowledge and attitude in this population as we hypothesise that there is generalised assumption in that being black is protective from POP.

The International Female Coital Incontinence Questionnaire (IFCI-Q): Development, Validation and Reliability Study

Coital urinary incontinence is an underestimated urinary symptom characterized by urine leakage during intercourse with a serious impact on female sexual function, which often may lead to the abandon of sexual activity. To date, there are no specific validated questionnaires for coital incontinence (CI). Aim of the study was to develop and validate a questionnaire "International Female Coital Incontinence- Questionnaire" (IFCI-Q) to evaluate the presence, severity and type of CI and its impact on quality of sexual intercourse. The IFCI-Q validation process included the following stages: (i) Questionnaire development and expert focus group (urologists and gynecologists experts in the field of functional urology); (ii) Administration of IFCI-Q to sexually active women complained for CI, by cognitive interview; (iii) Expert focus group to assess for content validity; (iv) Psychometric assessment of internal consistency by Cronbach's alpha calculation; (v) Test-retest reliability. Aim of the questionnaire was to evaluate the presence, severity and type of CI, its impact on quality of sexual intercourse and psychological status and to identify concomitant urinary symptoms. Psychometric properties outcomes: internal consistency and reliability are considered acceptable for Cronbach's α coefficient >0.7 and Cohen's k-test >0.6, respectively. Test-retest reliability was detected by administering the questionnaire twice to the all included women with a time interval of 2 weeks. The content validity was evaluated by a panel of clinical experts. Thirty women (mean ± SD age: 43.4 ± 17.1 years) complained of CI completed the IFCI-Q. A total of 43.4% of patients had OAB symptoms, 23.3% had mixed urinary incontinence (UI) and 6.6% complained of stress UI. Patients with CI during penetration had a higher prevalence of predominant SUI (7/10), and all women suffering from CI during orgasm had OAB symptoms (11/11). A total of 80% women feel depressed and 56.6% patients reported that CI restricts their sexual activity. Internal consistency and replicability of data were in the adequate range (Cronbach α=0.737). The test-retest procedure revealed that the k-values of each item are very good. IFCI-Q is a reliable questionnaire on CI and demonstrated a high level of internal consistency and reliability. Gubbiotti M, Giannantoni A, Rubilotta E, et al. The International Female Coital Incontinence Questionnaire (IFCI-Q): Development, Validation and Reliability Study. J Sex Med 2022;19:158-163.

PD44-12 POSITIVE ASSOCIATION BETWEEN LOWER URINARY TRACT SYMPTOMS AND COITAL URINARY INCONTINENCE IN NULLIPAROUS WOMEN

INTRODUCTION AND OBJECTIVE: Coital urinary incontinence (CUI) is a clinical problem with significant impact on quality of life, yet continues to be infrequently studied and underdiagnosed. CUI has been shown to have a prevalence of 10-66% in women with urinary incontinence but it has not been well-studied in a nulliparous population, where the presence of CUI may be particularly distressing. The objective of our study was to examine the association of CUI and other lower urinary tract symptoms (LUTS) in nulliparous women (NW). METHODS: An IRB approved, cross-sectional electronic survey was administered to women ≥ 18 years old with a secondary analysis aimed to evaluate the association between LUTS and CUI. We included all non-pregnant, nulliparous, female participants who completed the survey. Using responses to validated questionnaires including the ICIQ-FLUTS, we queried the prevalence of urgency, urgency urinary incontinence (UUI), stress urinary incontinence (SUI), overactive bladder (OAB), and CUI. Descriptive summary statistics were tabulated and Chi-squared tests were used to identify associations. RESULTS: Our cohort included 1,533 NW, of which 121(7.9%) reported CUI. The mean age was 31.2 years (SD 10.9) and mean BMI 24.7 (SD 5.5). There were no significant differences in age, BMI, race, education, smoking, or hysterectomy status between NW with and without CUI. In NW women with diabetes, 21.05% reported CUI, compared to 7.56% of NW without diabetes (p=0.002). Compared to NP without CUI, NP with CUI were more likely to have stress urinary incontinence (10.91% vs 39.67%, p<0.001), urge urinary incontinence (8.36% vs 23.97%, p<0.001), overactive bladder (18.27% vs 42.15%, p<0.001), and urinary urgency (14.80% vs 32.23%, p<0.001). CONCLUSIONS: A low but significant percentage of nulliparous women experience CUI. The presence of LUTS with or without incontinence in NP was found to have a strong positive association with CUI. Further research is needed in this population in order to identify the degree of bother and treatment strategies for CUI in order to better address this under-diagnosed condition.Source of Funding: CTSA award No. UL1 TR002243 from the National Center for Advancing Translational Sciences

Development and validity of a questionnaire for coital urinary incontinence: clinical and urodynamic analysis.

To develop and validate a questionnaire (coital incontinence questionnaire-CIQ) for CI and perform clinical and urodynamic analysis of patients with CI. A total of 414 female patients with urinary incontinence undergoing urodynamics were included in this study. All patients were evaluated with a detailed history, questionnaires, physical examination, relevant laboratory tests and urodynamics. Content, construct and convergent validity of the questionnaire were evaluated. Patients were divided into groups: with CI (group 1) and without CI (group 2). Overall test-retest reliability coefficients of CIQ were high (r = 0.968, p = 0.01), and the internal consistency was excellent (Cronbach's alpha, 0.964). The test-retest scores did not show a statistically significant difference (p= 0.158). Approximately 34% of these women had CI. Body mass index (BMI), parity, daily incontinence episodes, daily pad counts and 1-h pad test results were higher in group 1 than group 2 (p < 0.05). Multivariate analysis revealed that a daily incontinence episode, BMI, maximum cystometric capacity and PdetQmax were statistically significant factors associated with CI. Urinary incontinence types were different between groups (p < 0.0001). Incontinence with both penetration and orgasm was the most common form of CI (54.4%), and CI severity differed significantly among the forms of CI (p = 0.007). CI negatively interferes with patients' sexual life, their relationship with their partner and quality of life in most patients. The CIQ is a reliable, valid and useful tool for assessment of all aspects of CI in women. CI seems to be related to the severity of urinary incontinence. Further studies are needed to clarify this subject.

L’incontinence coïtale

Urinary incontinence may seriously impact quality of life, self-image and subsequently the sexual life. Beside this fact, urinary leakage can specifically occur during sexual intercourse, formally named coital incontinence, and thus lead to specific alteration of the sexual life. To analyse the prevalence, pathophysiological mechanisms and possible therapeutic options for coital urinary incontinence. Related terms to urinary incontinence and sexual dysfunction were search on PubMed database. Whereas at least a quarter of incontinent women have a coital incontinence, this symptom was rarely spontaneously reported. Some women had only coital incontinence (7.6 to 20% of cases). In men, urinary incontinence during sexual intercourse was mainly observed after prostatectomy in 20 to 64% of cases. Coital incontinence requires precise assessment. Indeed, it can occur whatever the phase of coitus: local stimulation (20-30%), excitement (13-18%), penetration (62.9-68%), movements back and forth, orgasm (27-37.1%). Cervico-urethral hypermobility, sphincter incompetence, urethral instability, detrusor overactivity could be the principal physiopathological mechanisms. In men, the main cause was a stress incontinence secondary to sphincter deficiency. Specific therapeutic strategies have proved their effectiveness. The rehabilitative approach (RR=0.25, CI [0.06-1.01]), medicinal (anticholinergic were effective in 59% of cases) or surgical therapeutic (slings with an efficiency of 87%) was proposed to patients. Coital incontinence is a common and troublesome symptom. Its precise assessment may suggest a specific mechanism and thus a specific treatment.

Female sexual function associated with the use of tension free vaginal tape for stress urinary incontinence

IntroductionFemale urinary incontinence is a common problem in middle-aged women. Up to 50% of the adult female population have stress urinary incontinence, and the prevalence of sexual dysfunction in these women is around 50%. The aim of this study is to evaluate sexual function before and after a urinary incontinence surgical procedure using tension-free vaginal tape (TVT) or transobturator tape (TOT). Material and methodsA prospective study was conducted on 22 sexually active women who underwent TVT or TOT procedures for stress urinary incontinence by assessing the Female Sexual Function Index (FSFI) before, and 3 and 6 months after surgery. ResultsThe study included 22 women with a mean age of 48.3±6.46 years, who underwent TVT or TOT for stress urinary incontinence. The median abdominal leak point pressure (ALPP) was 85.5±17.2cm H2O, with a median pelvic organ prolapse quantification (POPQ) of 0.28±0.45. Female sexual function assessed with the FSFI improved in all the aspects of the questionnaire. The mean total FSFI score before surgery was 21.57±3.53, at 3 months after surgery it was 26.05±3 (P=0.0001), and at 6 months post-op it was 27.28±5.03 (P=0.001). Coital incontinence improved in 90% of the participants, and 95% responded that they were satisfied with the results of the procedure. ConclusionSexual function in women who underwent TVT and TOT procedures improved considerably up to 6 months after surgery. Coital urinary incontinence improved in most of the women. Despite the evidence being variable as regards the outcomes in terms of sexual function after TVT and TOT, it is considered that these procedures substantially improve sexual function in women with stress urinary incontinence.

Función sexual femenina asociada al uso de cintas libres de tensión para el manejo de la incontinencia urinaria de estrés

IntroductionFemale urinary incontinence is a common problem in middle-aged women. Up to 50% of the adult female population have stress urinary incontinence, and the prevalence of sexual dysfunction in these women is around 50%. The aim of this study is to evaluate sexual function before and after a urinary incontinence surgical procedure using tension-free vaginal tape (TVT) or transobturator tape (TOT). Material and methodsA prospective study was conducted on 22 sexually active women who underwent TVT or TOT procedures for stress urinary incontinence by assessing the Female Sexual Function Index (FSFI) before, and 3 and 6 months after surgery. ResultsThe study included 22 women with a mean age of 48.3±6.46 years, who underwent TVT or TOT for stress urinary incontinence. The median abdominal leak point pressure (ALPP) was 85.5±17.2cm H2O, with a median pelvic organ prolapse quantification (POPQ) of 0.28±0.45. Female sexual Function assessed with the FSFI improved in all the aspects of the questionnaire. The mean total FSFI score before surgery was 21.57±3.53, at 3 months after surgery it was 26.05±3 (P=.0001), and at 6 months post-op it was 27.28±5.03 (P=.001). Coital incontinence improved in 90% of the participants, and 95% responded that they were satisfied with the results of the procedure. ConclusionSexual function in women who underwent TVT and TOT procedures improved considerably up to 6 months after surgery. Coital urinary incontinence improved in most of the women. Despite the evidence being variable as regards the outcomes in terms of sexual function after TVT and TOT, it is considered that these procedures substantially improve sexual function in women with stress urinary incontinence.

Coital Urinary Incontinence Induced by Impairment of the Dorsal Nerve of the Clitoris in Rats

We determined the effect of chronic bilateral neurectomy of the dorsal nerve of the clitoris on urinary parameters and sexual behavior of conscious female rats. A total of 18 anesthetized virgin female Wistar rats were used in this study, including 11 that underwent bilateral neurectomy of the dorsal nerve of the clitoris and 7 that underwent sham surgery. Urinary parameters were determined in awake animals preoperatively, and 3 and 10days postoperatively. Sexual behavior was tested 14 days postoperatively to determine whether the females expelled urine during sexual encounters. After male ejaculation the females were anesthetized with urethane to record external urethral sphincter electromyogram activity in response to clitoris, perigenital skin and vaginal stimulation. Neurectomy was corroborated anatomically. Sham surgery did not significantly modify urinary parameter values. However, bilateral neurectomy of the dorsal nerve of the clitoris significantly increased voiding frequency and voiding duration (p <0.05). It did not significantly affect the flow rate, voided volume or voiding interval. Of females that underwent bilateral neurectomy of the dorsal nerve of the clitoris 67% expelled urine just after male ejaculation. These results suggest that the pudendal nerve is an important neural pathway in the convergence and crosstalk of female urogenital neural circuits, and genital deafferentation may be a causal factor of coital urinary incontinence. Rats with bilateral transection of the dorsal nerve of the clitoris may serve as an animal model of coital incontinence.

MP12-13 COITAL URINARY INCONTINENCE IN RATS

You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Basic Research II1 Apr 2015MP12-13 COITAL URINARY INCONTINENCE IN RATS José Luis Palacios, Margarita Juárez, Raúl Juárez, Alfonso Medel, and Yolanda Cruz José Luis PalaciosJosé Luis Palacios More articles by this author , Margarita JuárezMargarita Juárez More articles by this author , Raúl JuárezRaúl Juárez More articles by this author , Alfonso MedelAlfonso Medel More articles by this author , and Yolanda CruzYolanda Cruz More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.788AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Urinary incontinence during sexual intercourse, referred as coital urinary incontinence, has a devastating impact on female sexuality and quality of life. The aim of the present study was to determine the effect of the bilateral neurectomy of the DNC on micturition in female rats. METHODS Fifteen anesthetized Wistar virgin female rats underwent bilateral neurectomy of the DNC (DNCNX, n=9) or sham surgery (SH, n=6). The micturition was recorded in awake animals 3 and 10 days post-surgery, during 6 h of the dark phase cycle. Sexual behavior was tested at day 14 post-surgery. In order to get sexual receptivity, 48 h previous to the test the females were treated with 10 □g of benzoate estradiol and 44 h later 2 mg of progesterone was injected. During the coitus the urinary meatus of the female was zoom recorded in order to determine urine expulsion. Means among groups were compared with ANOVA, with P<0.05 indicating a significant difference. RESULTS Sham surgery did not significantly modified the values of the urinary parameters. However, in DNCNX females voiding frequency (p<0.05) and voiding duration significantly increased (p<0.05). Flow rate, voiding volume and voiding interval were not significantly affected. Seventy percent of the DNCNX animals expelled urine just after a penile intromission or male ejaculation. CONCLUSIONS These results suggest that genital deaferentation may be a causal factor of female coital urinary incontinence. Rats with bilateral transection of the DNC may be used as an animal model of coital incontinence. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e132-e133 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information José Luis Palacios More articles by this author Margarita Juárez More articles by this author Raúl Juárez More articles by this author Alfonso Medel More articles by this author Yolanda Cruz More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

MP12-14 INVESTIGATIONS INTO THE MECHANISTIC LINK BETWEEN ELEVATED URINE BDNF LEVELS AND EXPRESSION OF CONNEXIN 43 IN BLADDER BIOPSY OF OVERACTIVE BLADDER PATIENTS

behavior was tested at day 14 post-surgery. In order to get sexual receptivity, 48 h previous to the test the females were treated with 10 ,g of benzoate estradiol and 44 h later 2 mg of progesterone was injected. During the coitus the urinary meatus of the female was zoom recorded in order to determine urine expulsion. Means among groups were compared with ANOVA, with P<0.05 indicating a significant difference. RESULTS: Sham surgery did not significantly modified the values of the urinary parameters. However, in DNCNX females voiding frequency (p<0.05) and voiding duration significantly increased (p<0.05). Flow rate, voiding volume and voiding interval were not significantly affected. Seventy percent of the DNCNX animals expelled urine just after a penile intromission or male ejaculation. CONCLUSIONS: These results suggest that genital deaferentation may be a causal factor of female coital urinary incontinence. Rats with bilateral transection of the DNC may be used as an animal model of coital incontinence.

Skene’s gland revisited: function, dysfunction and the G spot

Despite Skene’s gland being described over 300 years ago, and the frequent performance of surgery on and around these glands, it is remarkable how little we know about what they do and potential problems associated with them. Infection in these glands was described with gonorrhoeal infection in 1672 by Regnier de Graaf (1641–1693), which was long before Skene [1] described them in 1880. Controversy exists on the function of Skene’s glands, their role in sexual function, female orgasm and ejaculation, and even their anatomy. What is their role in the causation of urogynecological symptoms such as urethral pain and sexual dysfunction? Urogynaecological surgery in this area is commonplace for the treatment of urethral or paraurethral pathology, urinary incontinence or vaginal prolapse. What effect can this have on their function and sexual function more generally? In a histopathological study Wernert et al. [2] described Skene’s gland as a group of glands arranged in long ductal structures situated in the caudal two thirds of the urethra “mainly in the dorsal and lateral mucosal stroma but extending in some cases to the smooth musculature of the septum urethrovaginale”. These glands are not always present and were found in only two thirds of the 33 women they studied. They are “tubuloaveolar formations on long ductal structures” and resemble male prostate glands prior to puberty and androgenic stimulation. They contain prostate-specific antigen (PSA) and prostatic acid phosphatase (PAP) on immunostaining [2]. A more recent study [3] has confirmed the presence of prostate-specific antigen reactivity in the paraurethral tissues and in the “superficial layer of the female secretory (luminal) cells of the female prostatic glands and membranes of secretory and basal cells and membranes of cells of pseudostratified columnar epithelium of the ducts”. These ductal structures run longitudinally around the distal urethra located on the anterior vaginal wall. The literature is unclear on whether the glands open through a single or multiple orifices either into the distal urethra (similar to the male prostate) or a single duct orifice onto the left and right sides of the external urethral orifice. However it is my experience in asymptomatic women (Fig. 1) or where there is infection and abscess formation (Fig. 2), there is a single duct external to the urethral meatus. The distal urethra and vagina have an intimate relationship with the clitoris, both anatomically and functionally. The clitoris consists of an exterior glans, a midline densely neural nonerectile structure that is continuous with the erectile tissue of the paired bulbs and crura, which surround the distal urethra and vagina. The distal urethra, vagina and clitoris have a shared vasculature and nerve supply (the dorsal nerve to the clitoris) and form a tissue cluster described by O’Connell et al. [4] as the “locus of female sexual function and orgasm”. These tissues around the distal urethra become engorged with sexual arousal, but there is debate whether secretions are produced during coitus by Skene’s gland, or if ejaculation with orgasm occurs, similar to the male prostate. Heath [5] proposed that a large amount of lubricating fluid can be secreted from this gland similar to a “female ejaculation" when stimulated from inside the vagina and to such an extent that it can be mistaken for urine and coital urinary incontinence. If this does occur, it is an uncommon cause Related articles can be found at doi:10.1007/s00192-011-1461-9 and doi:10.1007/s00192-011-1488-y.

Incontinencia de orina durante la actividad sexual coital. Síntomas asociados y gravedad de la incontinencia

IntroductionThe objective of present study was to analyze the relationship between coital urinary incontinence (UI) and the symptoms of Stress UI (SUI), Urge UI (UUI) and the extent to which they impair the patient’s life, measured through the ICIQ-UI SF questionnaire in a sample of sexually active women with UI symptoms. MethodsEpidemiologic, observational, cross-sectional and multicentric study of 1,735 women with diagnostic of urinary incontinence (UI). Patients who were not sexually active were excluded, remaining 1,292 patients for the analysis. All women filled in the ICIQ-UI SF questionnaire and the King’s Health Questionnaire (KHQ). ResultsAccording to KHQ, the prevalence of coital incontinence was 29.4%. Women with coital incontinence compared to those who did not suffer from it, had similar mean age and body mass index, were more likely to have symptoms of SUI (37.6% vs. 27.7%) and less likely to have UUI (16.6% vs. 27.4%) (p<0.001). 36.1% of women with SUI had coital UI; this percentage was lower for women with UUI (20.1%). ICIQ-UI global score was higher in women with coital incontinence, 14.1 vs. 12.1 (p<0.001), difference that was mainly due to the dimension “affectation” rather than “frequency” and “amount” dimension scores. DiscussionCoital IU seem to be associated to SUI and to a higher severity of the urinary incontinence measured by the ICIQ-UI SF. Probably this association is due to the fact that ICIQ-UI-SF includes in its score the impact of patients’ UI symptoms on their life and coital incontinence has an important effect on the quality of life of sexually active women.

Coital urinary incontinence: impact on quality of life as measured by the King’s Health Questionnaire

The aim of this present study was to measure the impact of coital urinary incontinence (UI) on sexually active women quality of life (QoL). Epidemiological, observational, cross-sectional, and multicenter study including 633 sexually active women seeking treatment for UI and/or overactive bladder in a gynecological clinic, aged between 24 and 83 years. All women filled out the King's Health Questionnaire-KHQ. With this questionnaire, we had a complete register of the different urinary symptoms, included coital UI, and the extent of how they affect patient's life and the measurement of impact on the patient's QoL by the KHQ score. Prevalence of coital incontinence in sexually active women was 36.2%, classifying this impact as low (59.8%), moderate (32.3%), and high (7.9%). Women reporting coital incontinence had similar mean age and body mass index (BMI) to those women without coital incontinence. Women with coital incontinence had higher scores (worse QoL) in all the dimensions and in the KHQ global score (p < 0.05). Coital incontinence was the only variable showing an independent relation to KHQ global score (B = 10.1; 95% confidence interval = 1.7-18.6) in a multiple regression model adjusted to age, BMI, and the other urinary symptoms under study. One third of the sexually active women with urinary symptoms had coital incontinence. Among sexually active women with urinary symptoms, patients with coital urinary incontinence had a higher impact on their QoL than those without coital incontinence. Coital incontinence is independently related to a KHQ high score, which suggest worse QoL.

Coital urinary incontinence in an Australian population.

A total of 1,012 patients referred to 4 urodynamic centres were questioned, and subsequently investigated. Coital incontinence was present in 192 of the 839 (23%), who were sexually active. Ninety-five patients (49%) had the urodynamic diagnosis of genuine stress incontinence, alone or in association with cystocoele or interstitial cystitis. Fifty-one (26.6%) had urodynamically proven detrusor instability with or without interstitial cystitis. Forty-five (23.4%) had dual pathology as the final urodynamic diagnosis.