Bretschneider C Emi, Smerdon Caroline, Bieber Brian, Goodrich Nathan, Griffith James, Lai H Henry, Hokanson James A, Kirby Anna C, Smith Abigail, Guerrero Magaly, Gutta Sreya, Flynn Kathryn E, John Karen, Bradley Catherine S
Department of Obstetrics and Gynecology, Feinberg School of Medicine, Chicago, IL 60611, United States.
Arbor Research Collaborative for Health, Ann Arbor, MI 48108, United States.
J Sex Med. 2025 Jun 3;22(6):1035-1042. doi: 10.1093/jsxmed/qdaf063.
Bothersome lower urinary tract symptoms (LUTS) can negatively affect the quality of life in women, including sexual function.
The primary aim of the study was to explore the association between LUTS severity and sexual functioning among women with LUTS.
Female participants enrolled in the Symptoms of the first Symptoms of Lower Urinary Tract Dysfunction Research Network (LURN-I) observational cohort study with a frequency rating of at least "sometimes" and a bother rating of at least "somewhat" on at least one LUTS Tool question. LUTS and sexual function were quantified by patient questionnaires at baseline, 3 months, and 12 months after study enrollment. LUTS were assessed via the LUTS Tool, while sexual function was assessed using the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire, International Urogynecological Association-Revised (PISQ-IR). Longitudinal analyses were restricted to females with completed baseline and 12-month (or 3-month, if missing) questionnaires. Associations between baseline sexual function, clinical characteristics, and LUTS were analyzed using linear regression.
The primary outcomes were bothersome LUTS, defined by the LUTS Tool, and sexual function, defined by the PISQ-IR.
Female participants (n = 528) were identified. At baseline, 245 participants were not sexually active (NSA), while 283 were sexually active (SA). Baseline characteristics of the cohort are described in Table 1; compared with NSA, SA was younger (49 vs 63 years) and more likely to be married/civil union (67% vs 43%). Less severe LUTS (10 points lower) was associated with higher (better) PISQ-IR summary and subscale scores (condition-specific, condition-impact, global quality, and arousal/orgasm subscales) for SA participants. For NSA participants, less severe LUTS was associated with higher condition-specific and condition-impact subscale scores. A subset of participants (n = 406) had follow-up data at 12 months. Longitudinally, LUTS Tool scores improved on average from baseline to 12 months by seven points, while PISQ-IR scores generally remained stable.
As LUTS improves, overall sexual function in SA and NSA women remains stable.
Strengths of the study include the use of a validated sexual function questionnaire, PISQ-IR, which captures sexual function in women who are not SA. Limitations of the study include the fact that participants presented to tertiary academic centers for care, which may limit the study's generalizability.
In a large cohort of women with prospectively collected data on LUTS and sexual function, sexual function largely remained stable over time even as LUTS bother improved.
令人烦恼的下尿路症状（LUTS）会对女性的生活质量产生负面影响，包括性功能。
本研究的主要目的是探讨LUTS严重程度与患有LUTS的女性性功能之间的关联。
纳入下尿路功能障碍研究网络首个症状研究（LURN-I）观察性队列研究的女性参与者，她们在至少一个LUTS工具问题上的频率评分至少为“有时”，困扰评分至少为“有点”。在研究入组后的基线、3个月和12个月时，通过患者问卷对LUTS和性功能进行量化。通过LUTS工具评估LUTS，而使用国际尿控协会修订版盆底器官脱垂/尿失禁性功能问卷（PISQ-IR）评估性功能。纵向分析仅限于完成基线和12个月（或3个月，若缺失则为3个月）问卷的女性。使用线性回归分析基线性功能、临床特征和LUTS之间的关联。
确定了女性参与者（n = 528）。在基线时，245名参与者无性生活（NSA），而283名有性生活（SA）。队列的基线特征见表1；与NSA相比，SA更年轻（49岁对63岁），更可能已婚/处于民事结合关系（67%对43%）。对于有性生活的参与者，LUTS严重程度较低（低10分）与较高（更好）的PISQ-IR总分及各子量表得分（特定情况、情况影响、总体质量和性唤起/性高潮子量表）相关。对于无性生活的参与者，LUTS严重程度较低与较高的特定情况和情况影响子量表得分相关。一部分参与者（n = 406）有12个月的随访数据。纵向来看，LUTS工具评分从基线到12个月平均改善了7分，而PISQ-IR评分总体保持稳定。
随着LUTS改善，有性生活和无性生活女性的总体性功能保持稳定。
本研究的优点包括使用了经过验证的性功能问卷PISQ-IR，该问卷可捕捉无性生活女性的性功能。研究的局限性包括参与者是到三级学术中心就诊，这可能会限制研究的普遍性。
在一大群前瞻性收集了LUTS和性功能数据的女性中，即使LUTS困扰有所改善，性功能在很大程度上随时间保持稳定。
