Prevalence of sexual activity in waiting list women for pelvic organ prolapse and/or urinary incontinence surgery: a cross sectional survey

Objective. To assess the sexual activity in women who are in waiting list for surgical treatment of pelvic organ prolapse and/or urinary incontinence. Material and methods. Between January 2005 and December 2007, 671 patients referred for surgical repair of pelvic organ prolapse and/or urinary incontinence, were assessed for sexual activity by a cross sectional survey. Eligibility criteria for surgery were set as pelvic organ prolapse > 2 (pelvic organ prolapse was assessed according to B&W and pelvic organ prolapse-Q systems), urinary incontinence, according to the ICS definition, and age ≥ 18. All patients were assessed by history, clinical examination, Urogenital Distress Inventory-6 and Incontinence Impact Questionnaire-7 questionnaires, bladder diary, urine culture and pelvic ultrasound. All the women were asked if in the past three months had sexual activity with a partner. Sexual activity was defined as caressing, foreplay, masturbation and vaginal intercourse. Those who had not been sexual active were asked if they had a partner at that time. Results. Over 671 patients, 225 (33.5%) did not report any sexual activity while 446 (66.5%) had have in the three months before their referral some sort of sexual activity. The mean age of patients with sexual activity was statistically significant lower, that the group without (p 0.0001). No statistical significant difference was recorded about body mass index (p 0.089), Incontinence Impact Questionnaire (p 0.74) and Urogenital Distress Inventory (p 0.53). The women with sexual activity in the last three months showed a lower incidence of rectocele (p 0.011), hysterocele (p 0.003), number of vaginal delivery (p 0.006) and a positive PC test (p 0.001). Non significant difference were recorded regarding the presence/absence of comorbidities (hypertension, anxiety, thyroid diseases, ischemic cardiopaty, diabetes). 95.6% of patients without sexual activity were in menopause and 71.1% of women without sexual activity presented urinary incontinence Conclusions. The distress due to know undergoing surgery for pelvic organ prolapse or urinary incontinence, seems to not increase the prevalence of sexual dysfunction in waiting list women.