LONG BEACH, CALIF. – Women with urinary incontinence who were successfully treated nonsurgically showed significantly greater improvement in sexual function than women whose incontinence did not improve, a study has shown.
Three months after treatment with behavioral therapy, a continence pessary, or both, women whose treatment was successful had a 2.3-point mean improvement in their score on the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12). Women whose incontinence treatment was not successful had a 0.5-point mean improvement on the PISQ-12. The difference was statistically significant, said Dr. Victoria L. Handa of Johns Hopkins University, Baltimore.
Dr. Handa’s study was a planned, prospective secondary analysis of results from the Ambulatory Treatments for Leakage Associated With Stress (ATLAS) trial. That trial involved 445 women with stress urinary incontinence (SUI) or mixed incontinence in which SUI predominated. The women were randomized to receive behavioral therapy, consisting mostly of pelvic muscle training; a continence pessary; or both. The women were a mean of 50 years old, and about 46% had SUI only.
At baseline, women with mixed incontinence scored significantly worse on the PISQ-12 than those with SUI. In particular, they were more likely to report urinary incontinence with sexual activity, and to say that they restricted their sexual activity because of fears of incontinence.
After 3 months of follow-up, there were no significant differences among the three treatment groups on any measure of sexual function.
"I think there is this perception that Kegel exercises are good for sexual function, but in a separate analysis, we didn’t see any association between improvement in pelvic muscle function as measured by Brink score and any measure of sexual function," Dr. Handa said at the annual meeting of the American Urogynecologic Society.
In addition to showing significant improvements in total PISQ-12 scores, women who were successfully treated had significant improvements in two specific symptoms. They were less likely to report urinary incontinence with sexual activity, and less likely to say that they restricted their sexual activity because of fears of incontinence.
The National Institute of Child Health and Human Development sponsored the trial. Dr. Handa said she had no financial disclosures.