Sexual function in women with uterovaginal prolapse and urinary incontinence

Objective: To compare sexual function in women with and without uterovaginal prolapse and urinary incontinence. Methods: Eighty women with prolapse and with or without incontinence and 30 continent women without prolapse completed questionnaires assessing sexual function and underwent a physical examination. Results: Women with prolapse were older than those without prolapse (mean age ± standard deviation 58.2 ± 13.0 versus 49.2 ± 8.4 years, respectively; P <.001). The proportions of sexually active women were similar in both groups (56 and 57% for those with and those without prolapse, respectively). Measures of sexual function were not significantly different between the two groups. The mean global sexual function score was 0.58 ± 0.15 in the prolapse group and 0.55 ± 0.14 in the comparison group, a nonsignificant difference. The proportion of women with vaginal dryness or dyspareunia did not differ significantly between the two groups. Interest in sexual activity was unchanged in 70% of sexually active women with prolapse and incontinence, and 84% reported satisfaction with their sexual relationship. Twenty of 45 (44%) sexually active women with prolapse reported incontinence during sexual activity, and 14 (31%) reported that incontinence or prolapse interfered with sexual activity. After multivariate analysis, increasing age was the only significant factor predictive of a higher global sexual function score (P =.02), indicating worse sexual function. Increasing grade of prolapse predicted interference with sexual activity (P =.05), although this did not affect frequencyof intercourse or description of satisfaction with the sexual relationship. Conclusion: Women with prolapse and urinary incontinence do not differ from continent women without prolapse in measures of sexual function; age is the most important predictor of sexual function.