Stress urinary incontinence and genito-sexual conditions. Study of 35 cases

OBJECTIVES: To determine frequency and type of sexual disorders in stress urinary incontinence. To determine their physiopathologic mechanisms and psychologic impact. METHODS: 35 patients with stress urinary incontinence were prospectively investigated with special attention for sexuals disorders. Clinical examination, visual analogic scores testing psychologic impact, urodynamic investigation and electrophysiologic testing (electromyography, sacral latency and terminal pudendal nerve latency measurements) were performed. RESULTS: Sexual dysfunction was noted in 86% of the cases. Urinary incontinence during sexual intercourse was seen in 28%, anorgasmia noted in 60%. No correlation was demonstrated between different parameters (age, anorectal disorders, prolapsus, weight, pregnancy, visual analogic scales testing disturbance of the quality of life induced by urinary incontinence) and the presence of sexual dysfunction. CONCLUSION: This fact suggest that perineal stretch neuropathy, with progressive denervation of striated pelvic sphincter musculature due to repeated stretch injury of the innervation when the pelvic floor is weak, is not probably the most important factor to determine sexuals disorders. Psychogenic factors may be always considered in diagnosis and treatment.