Impact of stress urinary incontinence on female sexual activity.

OBJECTIVE: The study aimed to investigate the impact of SUI (Stress Urinary Incontinence) on the sexual activity of women, to assess their sexual functioning, and to show the extent of the problem that SUI poses to the quality of life of women. PATIENTS AND METHODS: The study involved 70 women aged 20-48 years. The inclusion criteria included the presence of stress urinary incontinence, the sexual activity of the women, and the history of no urogynecological intervention. The authorial questionnaire and the Polish version of the Female Sexual Function Index (FSFI) were used. RESULTS: SUI contributes to reducing the frequency of intercourse and even complete resignation from sexual intercourse. There is a correlation between the occurrence of urinary leakage during intercourse and the occurrence of sexual dysfunction (p=0.023). The most common factors limiting sexual activity are decreased libido, fatigue, lack of desire, and lack of body acceptance. However, age (p=0.070), marital status (p=0.091), Body Mass Index (BMI) (p=0.436), as well as the duration of stress urinary incontinence (p=0.36) have no effect on women's sexual activity. The most common ways of dealing with the loss of urine during intercourse include micturition before intercourse, intercourse only in safe places, restriction of physical activity during intercourse, and reduction of intercourse frequency and duration. CONCLUSIONS: SUI in women has a significant effect on their sexual activity. The cause of this state of affairs is multifactorial. Some women try to cope with the problem and have developed a number of strategies that allow them to be sexually active without unpleasant surprises.

Prediction of detrusor underactivity based on non-invasive functional tests and clinical data in patients with symptoms of bladder outlet obstruction.

OBJECTIVE: Detrusor underactivity (DU) is a common but relatively under-researched bladder dysfunction. Recently, there has been renewed interest in this topic. The aim of the study was to develop a decision-making algorithm to predict the impaired detrusor contractility in patients with LUTS (lower urinary tract symptoms). PATIENTS AND METHODS: A retrospective analysis covered 96 consecutive patients (aged 63 ± 8 years) treated pharmacologically for 50 ± 37 months due to LUTS (persisting for 64 ± 41 months). Functional tests included uroflowmetry and flow cystometry. RESULTS: Weakened detrusor functioning was detected in 58 (60.4%) patients. Decision-making algorithm that included uroflowmetry, flow cystometry and clinical data, was showed to allow to diagnose impaired detrusor function with accuracy of 73% (95% CI - confidence interval: 61-83%) and specificity of 76% (95% CI: 54-90%). The positive predictive value of the classification tree graph is equal to 90% (95% CI: 78 -96%) and the negative predictive value is 50% (95% CI: 34-66%). The weakened detrusor function was more frequent in patients with: time to reach maximum flow rate higher than 13.5 s; time to reach maximum flow rate lower than 13.5 s and mean flow ratio higher than 4.5 ml/s, but time of flow longer than 44.5 s; time to reach maximum flow rate lower than 13.5 s and mean flow ratio lower than 4.5 ml/s, but time of flow longer than 52.5 s. CONCLUSIONS: The results of the uroflowmetry can be used to predict the impaired detrusor contractility in patients with LUTS.