General Obstetrics and Gynecology: Gynecology
Sexual function among women with urinary incontinence and pelvic organ prolapse

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Objective

The objective of this research was to determine whether sexual complaints, such as dyspareunia, are associated with pelvic floor disorders.

Study design

We used data collected for the Maryland Women's Health Study. Among adult women scheduled for hysterectomy, we used multiple logistic regression analysis to identify characteristics associated with 4 sexual complaints: decreased libido, vaginal dryness, dyspareunia, and anorgasmia.

Results

Among 1299 participants, 495 (38.1%) had evidence of pelvic floor disorders. Sexual complaints were significantly more common among women with pelvic floor disorders (53.2% vs 40.4%, P < .01). In the multiple regression model, urinary incontinence was significantly associated with low libido (odds ratio [OR] 1.96), vaginal dryness (OR 2.11), and dyspareunia (OR 2.04), independent of age, educational attainment, and race. In contrast, pelvic organ prolapse was not associated with any sexual complaint.

Conclusion

In a cohort of women planning hysterectomy, women with urinary incontinence were significantly more likely to report sexual complaints.

Section snippets

Material and methods

The Maryland Women's Health Study was a prospective cohort study of 1299 women scheduled for hysterectomy in Maryland during 1992 and 1993. The design of this study has been described in detail previously.13 Briefly, of the 4858 women undergoing hysterectomy at participating hospitals during the study period, 1823 were identified before the hysterectomy and approached for enrollment. Of the patients contacted, 81% agreed to participate. Of the 1299 participants, the most common principal

Pelvic floor disorders

Among 1299 women scheduled for hysterectomy, we identified 495 women with pelvic floor disorders (38.1%). Six cases (0.5%) were excluded because of incomplete USSW data. The 495 cases of pelvic floor disorders included 99 women who had both prolapse and severe incontinence, 113 women who had prolapse without severe incontinence, and 283 women who had severe urinary incontinence without prolapse. When comparing women with and without pelvic floor disorders, we found that pelvic floor disorders

Comment

These data suggest that sexual complaints are strongly associated with urinary incontinence. Specifically, in this study, women with severe urinary incontinence were more likely to report low libido, vaginal dryness, and dysparuenia than women without severe incontinence. Similar findings were noted by Laumann et al.15 In a household survey of 1749 women, “urinary tract symptoms” were significantly associated with complaints of sexual pain (OR 7.61) and problems with arousal (OR 4.02). However,

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  • Cited by (0)

    Supported by grant HS06865 from the Agency for Health Care Policy and Research.

    Dr Siddique is an employee of the United States Navy.

    The opinions expressed herein are those of the authors and are not necessarily those of the United States Navy or the Department of Defense.

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