ABSTRACT
Women with pelvic floor complaints experience restrictions and distress in their daily, social, and sexual functioning, and their intimate relationships. We interviewed forty-eight women to unravel differences between women receiving and not receiving pelvic physical therapy and between pregnant, parous, and nulliparous women in preparation for theory development. We analyzed data in a mixed-method design using NVivo and Leximancer. Sexual dysfunction, relationship dynamics, the nature and severity of restrictions and distress, and coping strategies appear to vary between women receiving and not receiving therapy. Specific combinations of restrictions and distress are present in pregnant, parous, and nulliparous women, and might influence women's decision to seek help.
Subject(s)
Pelvic Floor , Sexual Dysfunction, Physiological , Pregnancy , Female , Humans , Sexual Partners , Adaptation, PsychologicalABSTRACT
OBJECTIVES: To determine whether sacral neuromodulation (SNM) for urinary symptoms or fecal incontinence gives improvement of female sexual function and whether improvement is due to physiological or psychological factors. METHODS: Between 2002 and 2008, 8 patients had an array of questionnaires before and after SNM implantation. The questionnaires were: the Questionnaire for Screening for Sexual Dysfunctions, the Golombok Rust Inventory of Sexual Satisfaction, the Symptom Checklist-90, the Maudsley Marital Questionnaire and the McGill-Mah Orgasm Questionnaire. Three of these 8 patients underwent vaginal plethysmography before and after implantation. RESULTS: No statistically significant changes were found, although there seems to be a trend toward improvement in orgasm scores. In plethysmography all 3 patients showed increased vaginal pulse amplitude with the stimulator turned on with both erotic and non-erotic stimuli. CONCLUSIONS: This study does not show a clear effect of SNM on sexual function, although there seems to be an improvement in orgasm scores. The lack of response on psychological questionnaires and the increase in vaginal pulse amplitude after SNM implantation indicate that there might be a physiological response.
Subject(s)
Electric Stimulation Therapy , Fecal Incontinence/therapy , Lower Urinary Tract Symptoms/therapy , Sacrum , Sexual Behavior , Sexual Dysfunction, Physiological/therapy , Vagina/innervation , Electric Stimulation Therapy/instrumentation , Fecal Incontinence/complications , Fecal Incontinence/physiopathology , Fecal Incontinence/psychology , Female , Humans , Implantable Neurostimulators , Lower Urinary Tract Symptoms/complications , Lower Urinary Tract Symptoms/physiopathology , Lower Urinary Tract Symptoms/psychology , Netherlands , Orgasm , Patient Satisfaction , Plethysmography , Prospective Studies , Sexual Dysfunction, Physiological/etiology , Sexual Dysfunction, Physiological/physiopathology , Sexual Dysfunction, Physiological/psychology , Sexual Dysfunctions, Psychological/etiology , Sexual Dysfunctions, Psychological/physiopathology , Sexual Dysfunctions, Psychological/psychology , Sexual Dysfunctions, Psychological/therapy , Surveys and Questionnaires , Treatment OutcomeABSTRACT
The objective of this study was to investigate the predictive validity of the Dutch translation of the Golombok Rust Inventory of Sexual Satisfaction (GRISS) for the presence of clinically relevant sexual dysfunctions and patient's need of help. A total of 57 male urological outpatients (age 50.7+/-13.2 y; range 27-77 y) completed the GRISS, a 28-item self-report questionnaire assessing sexual dysfunctions and sexual satisfaction in heterosexual relationships. GRISS subscales were found to differentiate multivariately between men with and without sexual dysfunctions. The erectile dysfunction (In the original English version of the GRISS, the term 'impotence' was used instead of 'erectile dysfunction'), dissatisfaction, and infrequency subscales also differentiated univariately between these groups. The predictive validity for the presence of sexual dysfunctions and for the patients' need for professional help was investigated. Prediction models, derived by means of logistic regression analysis, were tested in a crossvalidation sample. Sensitivity and specificity for the presence of sexual dysfunctions, as well as the predictive values positive and negative were found to be satisfactory. The predictive validity of the GRISS was found equally satisfactory for the patients' need for professional help. The discriminant and predictive validity of the GRISS in men with and without sexual dysfunctions appeared satisfactory. Routine use of the GRISS appears warranted for the screening of sexual dysfunctions in new urological patients.
