Dados do Trabalho

Título

IMPACT OF URINARY INCONTINENCE ON SEXUAL ACTIVITY AND SATISFACTION OF WOMEN WITH SPINAL CORD DISEASES

Introdução e Objetivo

Urinary incontinence (UI) is common in women with spinal cord diseases (SCD) and may be detrimental to sexual function and quality of life. We evaluated the impact of bladder management, UI and other health parameters on sexual function and sexual life satisfaction (SxSFT) in this population.

Método

Women with SCD from different causes were evaluated in a cross-sectional study. Participants completed a structured questionnaire, the Neurogenic Bladder Symptom Score short form (NBSS-SF), the Female Sexual Function Index (FSFI) and the Whoqol-bref for the evaluation of quality of life. UI was defined as leakage occurring at least a few times/week. Severe UI was defined as leakage occurring ≥ 1/day AND patients using ≥ 3 pads/day. SxSFT was defined when patients reported to be either “satisfied” or “very satisfied” on the sexual question of the Whoqol-bref. We assessed the association between UI, bladder management and other parameters with sexual activity and SxSFT.

Resultados

Ninety-eight women with a median age of 42.5 [32-51] years were evaluated. Multiple sclerosis was the main etiology (55.9%), followed by traumatic SCD (14.3%). Median duration of neurological disease was 10 [7-16] years and 21 (21.4%) were wheelchair bound. Forty-two (42.9%) were married and 28 (28.6%) were menopausal. Clean intermittent catheterization (CIC) was the method of bladder management of 25 (25.5%) women and 65 (66,35%) had spontaneous voiding.  UI was reported by 51 (52.0%) and severe UI, by 28 (28.6%). Forty-eight (49.0%) women were sexually active of which 22 (45.8%) were satisfied. Predictors of sexual activity were age, being married, pre menopause, not using a wheelchair, being continent and not needing CIC (table). SxSFT was associated with being married (OR 13.8 [IC95%4.2-45.4, p<0.001]), continent (OR 6.0 [IC95%2.0-18.2, p<0.001]) and younger (OR 0.93 [IC 95% 0.9-1, P=0.009]. Sexual dysfunction was strongly associated with dissatisfaction (OR 34.2 [IC95%4.6-372.0, p<0.001).      

Conclusão

 SCD dramatically impacts on female sexuality, and UI is strongly associated with sexual inactivity and dissatisfaction. Our results highlight the importance of proper evaluation and treatment of UI in this population.