Female Sexual Function and the Pelvic Floor

Sarit O. Aschkenazi;   Roger P. Goldberg

Disclosures

Expert Rev of Obstet Gynecol. 2009;4(2):165-178. 

In This Article

Coital Incontinence

An important aspect of urinary incontinence and sexual function is the symptoms of coital incontinence. There are limited studies addressing this particular aspect of urinary incontinence. One study examined urinary incontinence at orgasm and its relation to detrusor overactivity and treatment efficacy[72]. The authors found that incontinence at orgasm is associated with DO in the majority of cases studied. Women with DO complaining of incontinence at orgasm did not respond as well to antimuscarinic treatment compared with women without coital incontinence. However, coital incontinence is also associated with SUI. In a study assessing sexual function following the placement of a midurethral retropubic sling, authors found that, following the sling procedure, there were significantly fewer episodes of orgasm incontinence and penetration incontinence[73].

One study on 633 sexually active women seeking treatment for urinary incontinence evaluated the impact of coital urinary incontinence on quality of life as measured by the King's Health Questionnaire[74]. A third of the sexually active women with urinary symptoms suffered from coital incontinence. Women with coital urinary incontinence had a significantly higher adverse impact on their quality of life than those without coital incontinence. Another study aimed to evaluate the impact of coital incontinence on health-related quality of life in 180 women with lower urinary tract symptoms[75]. Women with coital urinary incontinence had more severe symptoms, according to validated questionnaires, including frequency, urgency, urge incontinence, bladder pain, stress incontinence, unpredictable incontinence, nocturia and nocturnal enuresis, than women without complaints of coital incontinence. Subjects with coital incontinence had more health-related quality-of-life impairment than those without coital incontinence. The authors concluded that coital incontinence is associated with more severe quality-of-life impairment and that more emphasis should be placed on coital incontinence in the terminology of urinary incontinence.

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