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How do urinary incontinence and urgency affect women's sexual life?

Objective. To investigate the impact of urinary incontinence and urgency on women's sexual life and the prevalence of urinary leakage during sexual activity. A further aim was to explore factors affecting sexual desire and satisfaction with sexual life. Design. A semi‐structured questionnaire study. Setting and Sample. Sexually active women (n=147) aged 18–74years with urinary incontinence and urgency were recruited from four outpatient clinics. Methods. The women completed questionnaires concerning medical history, psychosocial situation, partner relationship and sexual life, and answered the Bristol Female Lower Urinary Tract Symptoms questionnaire. All underwent clinical evaluation. Main Outcome Measures. Prevalence of urinary leakage during sexual activity, factors affecting sexual desire and sexual satisfaction. Results. The vast majority considered sexuality to be important in their lives. One‐third of the women had urinary leakage during sexual activity. Half reported that sexual life was more or less spoiled due to their urinary incontinence or urgency and they were worried about having urinary leakage during intercourse, and almost two‐thirds worried about odor and felt unattractive. The women's dissatisfaction with sexual life was strongly correlated to unsatisfying psychological health, orgasmic disability and worry about urinary leakage during intercourse. Insufficient vaginal lubrication, unsatisfying psychological health and their partners’ ill health were significantly correlated with decreased sexual desire. Conclusions. Urinary incontinence and urgency have a negative impact on women's sexual life. Thus, a dialogue about sexual function in women with urinary symptoms should become an integral component in clinical management.