Psycho-relational aspects of urinary incontinence in female sexuality

Abstract

Urinary incontinence (UI) is a very common disorder in women, involving severe consequences on the patients' perception of quality of life and sexuality. The aim of this contribution is to analyze the psycho-relational aspects linked to UI, focusing on sexual activity, self-perception of sexual competence and self-esteem. Urinary incontinence causes feelings of shame and inadequacy as well as low self-esteem; it may affect sexual activity, reducing sexual intercourse frequency. Many authors highlight a strong comorbidity between urinary incontinence and sexual dysfunctions, such as dyspareunia, vaginismus, hypo-active sexual desire, arousal and orgasm disorders. Literature analysis shows that changes in sexual activity are influenced not only by urinary incontinence symptoms but also by the disorder self-perception, by previous sexuality, menopause, social status and the partner's attitude. The etiological study of urinary incontinence shows that several different factors play a role in this disorder. Therefore, an integrated therapeutic approach is suggested, considering, besides the organic issues, the experience and feelings of patients as well as the consequences on their sexual and social life.

Comparative Assessment of Female Sexual Function Following Transobturator Midurethral Sling for Stress Urinary Incontinence

“…However, the patients admitted that after surgery, they experienced greater sexual arousal during sexual activity. According to the publication by Simonelli [44], as many as 30.5% of the surveyed women report a decrease in sexual activity caused by fear of orgasm and the symptoms of "losing" urine that may accompany it.…”

Female Sexual Dysfunctions and Urogynecological Disorders

“…[26][27][28][29][30][31] The loss of urine significantly impairs the QoL of women, who are forced to organise exhausting strategies to prevent or mask stains and/or odours. 32 At emotional and behavioural levels, a generalised apathy, feelings of guilt and depressive attitude may develop to different areas of life due to the unpredictable nature of the symptoms. 33 Thus, several studies showed a correlation between UI and major depression, which has a three times higher incidence in incontinent patients than in continent patients.…”

9 Percutaneous Tibial Nerve Stimulation for Overactive Bladder Syndrome: a single-arm trial

“…Objective: Overactive bladder (OAB) is estimated to affect 11.8% of women worldwide causing diminished quality of life, feelings of guilt, apathy, reduced self-esteem and depressive symptoms. 1,2 Lifestyle modifications and muscarinic receptor antagonist remain the mainstay of treatment, but are limited by their efficacy and adverse effects. Access to third-line therapies of intravesical botox or sacral neuromodulation is limited by its invasive nature.…”