Clinical
Female Sexual Dysfunction
Djordje Nale Clinic of Urology, Belgrade
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Abstract Centre
The role of partnership in the sexual health of women with urinary incontinence is central and multidimensional. The partnership has a significant impact on psychological well-being, sexual function and treatment outcomes. The objective of our study was to investigate the role of the partner in sexual activity in incontinent women, using partner – related domain of validated questionnaire PISQ-12.
This study was clinical-epidemiological and cross-sectional. A consecutive sample of 660 female patients with different types of urinary incontinence attending the Clinic of urology were invited to participate in this study. The inclusion criteria were that patients must be: 18 years or older, sexually active within the past 6 months, able to read and write Serbian, not pregnant, and have no history of pelvic/gynecological surgery or radiation. All included patients were those having their first visit for urinary incontinence/POP and willingly volunteering to participate in the study. Patients who did not meet all of the inclusion criteria were excluded. In addition, women who were on hormonal replacement therapy for menopause, had a functional disability, and/or had psychotic disorders including schizophrenia were excluded from our study. The control group included 112 women without UI and/or POP. After patients completed the PISQ-12 questionnaire, they were examined by a physician who determined the type of their incontinence and any degree of POP via standardized assessment and POP-Q stage.
Demographic and clinical characteristics of women with incontinence/POP and control are presented in Table 1. A significantly higher incidence of sexually active women in the control group was registered compared to incontinent women (p-value=0.000). Better sexual function was also registered in women without pelvic floor dysfunction, assessed with the total PISQ-12 questionnaire and partner – related domain of questionnaire PISQ-12 (Table 1.) Study group Control Group p value (n=660) (n=112) Age (years) 58.4±11.0 (4)* 49.8±8.9 (1)* <0.001 BMI (kg/m2) 27.6±8.5 (19)* 26.7±17.0 (1)* 0.389 Parity 1.9±0.7 (8)* 1.5±0.9 (1)* <0.001 Education (13)* (1)* Elementary (8 grades) 12 (20%) 17 (15%) 0.538 High school (12 grades) 361 (56%) 66 (59%) Further Education 158 (24%) 28 (26%) Marital status Married or in relationship 489 (74%) (6)* 94 (85%) (1)* 0.023 Single, divorced or widow 165 (26%) 17 (15%) Menopause 511 (78%) (8)* 52 (47%) (1)* <0.001 Sexually active 374 (57%) (2)* 103 (92%) <0.001 PISQ-12 Total 30.84±6.82 38.19±5.61 <0.001 Behavioral-Emotive 9.71±2.89 11.40±3.21 <0.001 Physical 13.46±4.41 18.46±2.79 <0.001 Partner-Related 7.72±1.84 8.33±1.81 0.003
Sexual activity in women with urinary incontinence is not only an individual construct but includes a significant partner-related dimension, as demonstrated by validated instruments such as the PISQ-12.
The partner acts as either a protective factor or a risk factor in the sexual activity of incontinent women. Integrating the partner into assessment is essential for comprehensive care. The partner-related domain of PISQ-12 provides limited insight into the partner’s role, as it reflects only the woman’s perception of her partner’s sexual function, without assessing broader relational and psychosocial aspects.
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