Department of Obstetrics and Gynecology, Division of Urogynecology, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey.
Int J Impot Res. 2020 Sep;32(5):535-543. doi: 10.1038/s41443-019-0219-7. Epub 2019 Dec 11.
Sexual function is important for health and quality of life. We evaluated effects of lower urinary tract symptoms (LUTS), urinary incontinence (UI) and coital incontinence, and/or pelvic organ prolapse (POP) on sexual functions and quality of life of women over 50 years of age. Secondary objectives were to compare rate of sexual activity, effects of type of UI and coital incontinence on sexual functions and quality of life among age groups. Female-Sexual-Function-Index (FSFI), Pelvic-Organ-Prolapse/Urinary-Incontinence Sexual-Function-Questionnaire-12 (PISQ-12), and King's-Health-Questionnaire (KHQ) were used for evaluation. Between 2013 and 2018, 1256 women were included. 565 women were 50-59 years (Group 1), 440 were 60-69 (Group 2), 251 were over 70 (Group-3). 763 women (60.7%) suffered from LUTS, 141 women (11.2%) suffered from POP only, and 352 women (28%) suffered from POP + LUTS. Younger women were more sexually active (p = 0.001). FSFI and PISQ-12 scores of women suffering from LUTS, POP + LUTS, and POP only were similar. Lubrication and orgasm scores were worse in Group 3 (p = 0.006 and 0.037). Type of UI did not affect FSFI and PISQ-12 scores. Coital incontinence was correlated with mixed UI in Groups 1 (p = 0.01) and 2 (p = 0.03). There was no association with coital incontinence and type of UI in Group 3. Coital incontinence had adverse effect in FSFI, PISQ-12 scores. In younger women, coital incontinence had an adverse effect on desire and arousal domains. KHQ scores were worse in women having LUTS in comparison to women suffering from POP only (p = 0.00) and were worse in Groups 1 and 2 (p = 0.002 and 0.013). KHQ scores were worse in women suffering from urge or mixed UI (p = 0.00). Coital incontinence had adverse effect in KHQ scores. In conclusion, aging, LUTS, UI, and coital incontinence have detrimental effects on sexual functions and quality of life. Urge or mixed UI have more adverse effects on quality of life. Quality of life is worse in younger women suffering from UI and coital incontinence.
性功能对健康和生活质量很重要。我们评估了下尿路症状(LUTS)、尿失禁(UI)和性交性尿失禁以及/或盆腔器官脱垂(POP)对 50 岁以上女性性功能和生活质量的影响。次要目标是比较性行为发生率、不同类型的 UI 和性交性尿失禁对不同年龄组女性性功能和生活质量的影响。使用女性性功能指数(FSFI)、盆腔器官脱垂/尿失禁性功能问卷 12 项(PISQ-12)和 King's 健康问卷(KHQ)进行评估。2013 年至 2018 年期间,共纳入 1256 名女性。565 名女性年龄在 50-59 岁(第 1 组),440 名年龄在 60-69 岁(第 2 组),251 名年龄在 70 岁以上(第 3 组)。763 名女性(60.7%)患有 LUTS,141 名女性(11.2%)仅患有 POP,352 名女性(28%)患有 POP+LUTS。年轻女性更活跃(p=0.001)。患有 LUTS、POP+LUTS 和 POP 仅的女性的 FSFI 和 PISQ-12 评分相似。第 3 组的润滑和性高潮评分更差(p=0.006 和 0.037)。UI 类型对 FSFI 和 PISQ-12 评分没有影响。性交性尿失禁与第 1 组(p=0.01)和第 2 组(p=0.03)的混合性 UI 相关。第 3 组中,性交性尿失禁与 UI 类型没有关联。性交性尿失禁对 FSFI 和 PISQ-12 评分有不良影响。在年轻女性中,性交性尿失禁对性欲和唤起领域有不良影响。与仅患有 POP 的女性相比,患有 LUTS 的女性 KHQ 评分更差(p=0.00),第 1 组和第 2 组的 KHQ 评分更差(p=0.002 和 0.013)。患有急迫性或混合性 UI 的女性 KHQ 评分更差(p=0.00)。性交性尿失禁对 KHQ 评分有不良影响。总之,衰老、LUTS、UI 和性交性尿失禁对性功能和生活质量有不利影响。急迫性或混合性 UI 对生活质量的影响更大。患有 UI 和性交性尿失禁的年轻女性生活质量更差。