Advertisement

International Urogynecology Journal

, Volume 29, Issue 7, pp 969–978 | Cite as

Evaluation of coital incontinence by electronic questionnaire: prevalence, associations and outcomes in women attending a urogynaecology clinic

  • Thomas GrayEmail author
  • Weiguang Li
  • Patrick Campbell
  • Swati Jha
  • Stephen Radley
Original Article

Abstract

Introduction and hypothesis

Coital incontinence is the involuntary leakage of urine during sexual intercourse and is divided into that occurring with penetration and that occurring with orgasm. Mechanisms of coital incontinence are poorly understood. The aim of this retrospective study was to measure the prevalence of coital incontinence and evaluate the association among various types of coital incontinence with stress urinary incontinence (SUI), overactive bladder (OAB) and impact on quality-of-life in women attending a urogynaecology clinic.

Methods

A total of 2,312 women completed the electronic Personal Assessment Questionnaire-Pelvic Floor (ePAQ-PF) in advance of their urogynaecology consultation. Logistic regression and Spearman’s rank-order correlation evaluated associations between types of coital incontinence and OAB and SUI. The Mann–Whitney test evaluated the relationship between coital incontinence and self-reported quality of sex life and self-avoidance and partner avoidance of sex. Subgroup analysis analysed outcomes in 84 women with coital incontinence undergoing treatment with tension-free vaginal tape (TVT).

Results

Prevalence of coital incontinence in the cohort was 30%. Symptoms of OAB (p < 0.005) and SUI (p < 0.005) were significantly and independently associated with both types of coital incontinence (orgasm and penetration). In women with coital incontinence compared with those without, there was significant self-avoidance of sex (p < 0.0005), partner avoidance of sex (p < 0.0005) and impaired quality of sex life due to sexual problems (p < 0.005). The impact of this was significant in each group. Subgroup analysis of 84 women undergoing TVT showed significant improvement in all coital incontinence symptoms 3 months post-operatively.

Conclusion

Using an electronic questionnaire before consultation has identified coital incontinence to be a prevalent symptom, having a significant impact on the patient’s sex life. Coital incontinence at orgasm and penetration are both significantly associated with SUI and OAB.

Keywords

Coital incontinence ePAQ-PF Questionnaire Computer interviewing TVT Orgasm 

Notes

Compliance with ethical standards

Conflicts of interest

Mr Stephen Radley is a director and shareholder of ePAQ systems limited, an NHS spin-out technology company (www.epaq.co.uk). The other authors declare that they have no conflicts of interest.

Funding statement

No funding was received for this study.

References

  1. 1.
    Haylen BT, De Ridder D, Freeman RM, Swift SE, Berghmans B, Lee J, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Int Urogynaecol J. 2010;21(1):5–26.CrossRefGoogle Scholar
  2. 2.
    Hilton P. Urinary incontinence during sexual intercourse: a common, but rarely volunteered, symptom. Br J Obstet Gynaecol. 1988;95(4):377–81.CrossRefPubMedGoogle Scholar
  3. 3.
    Pauls RN, Segal JL, Silva WA, Kleeman SD, Karram MM. Sexual function in patients presenting to a urogynecology practice. Int Urogynecol J. 2006;17(6):576–80.CrossRefGoogle Scholar
  4. 4.
    Gordon D, Groutz A, Sinai T, Wiezman A, Lessing JB, David MP, et al. Sexual function in women attending a urogynecology clinic. Int Urogynecol J. 1999;10(5):325–8.CrossRefGoogle Scholar
  5. 5.
    Jha S, Strelley K, Radley S. Incontinence during intercourse: myths unravelled. Int Urogynecol J. 2012;23(5):633–7.CrossRefPubMedGoogle Scholar
  6. 6.
    Pons ME, Clota MP. Coital urinary incontinence: impact on quality of life as measured by the King’s health questionnaire. Int Urogynecol J. 2008;19(5):621–5.CrossRefGoogle Scholar
  7. 7.
    Khan Z, Bhola A, Starer P. Urinary incontinence during orgasm. Urology. 1988;31(3):279–82.CrossRefPubMedGoogle Scholar
  8. 8.
    Madhu C, Hashim H, Enki D, Yaasin M, Drake M. Coital incontinence: what can we learn from urodynamic assessment? Urology. 2015;85(5):1034–8.CrossRefPubMedGoogle Scholar
  9. 9.
    Schussler-Fiorenza R, Rose S, Gangnon R, Chewing B, Wald A. Increasing discussion rates of incontinence in primary care: a randomized controlled trial. J Women’s Health. 2015;24(11):940–9.CrossRefGoogle Scholar
  10. 10.
    Jones GL, Radley SC, Lumb J, Jha S. Electronic pelvic floor symptoms assessment: tests of data quality of ePAQ-PF. Int Urogynecol J. 2008;19:1337–47.CrossRefGoogle Scholar
  11. 11.
    Bulchandani S, Toozs-Hobson P, Parsons M, McCooty S, Perkins K, Latthe P. Effect of anticholinergics on the overactive bladder and bowel domain of the electronic personal assessment questionnaire (ePAQ). Int Urogynecol J. 2015;26(4):533–7.CrossRefPubMedGoogle Scholar
  12. 12.
    Dua A, Jones G, Wood H, Sidhu H. Understanding women’s experience of electronic interviewing during the clinical episode in urogynaecology: a qualitative study. Int Urogynecol J. 2013;24(11):1969–75.CrossRefPubMedGoogle Scholar
  13. 13.
    Radley SC, Jones GL. Measuring quality of life in urogynaecology. Br J Obstet Gynaecol. 2004;111(1):33–6.CrossRefGoogle Scholar
  14. 14.
    Schäfer W, Abrams P, Liao L, Mattiasson A, Pesce F, Spangberg A, et al. Good urodynamic practices: uroflowmetry, filling cystometry, and pressure-flow studies. Neurourol Urodyn. 2002;21(3):261–74.CrossRefPubMedGoogle Scholar
  15. 15.
    Moran PA, Dwyer PL, Ziccone SP. Urinary leakage during coitus in women. J Obstet Gynaecol. 1999;19(3):286–8.CrossRefPubMedGoogle Scholar
  16. 16.
    Bekker M, Beck J, Putter H, Venema P, Pelger R, Elzevier H. Sexual function improvement following surgery for stress incontinence: the relevance of coital incontinence. J Sex Med. 2009;6(11):3208–13.CrossRefPubMedGoogle Scholar
  17. 17.
    El-Azab AS, Yousef HA, Seifeldein GS. Coital incontinence: relation to detrusor overactivity and stress incontinence. Neurourol Urodyn. 2011;30(4):520–4.CrossRefPubMedGoogle Scholar
  18. 18.
    Serati M, Salvatore S, Uccella S, Cromi A, Khullar V, Cardozo L, et al. Urinary incontinence at orgasm: relation to detrusor overactivity and treatment efficacy. Eur Urol. 2008;54(4):911–7.CrossRefPubMedGoogle Scholar
  19. 19.
    Vierhout ME, Gianotten WL. Mechanisms of urine loss during sexual activity. Eur J Obstet Gynecol Reprod Biol. 1993;52(1):45–7.CrossRefPubMedGoogle Scholar
  20. 20.
    Sutherst J, Brown M. Sexual dysfunction associated with urinary incontinence. Urol Int. 1980;35:414–6.CrossRefPubMedGoogle Scholar
  21. 21.
    Walters MD, Taylor S, Schoenfeld LS. Psychosexual study of women with detrusor instability. Obstet Gynecol. 1990;75:22–6.PubMedGoogle Scholar
  22. 22.
    Weber AM, Walters MD, Schover LR, Mitchinson A. Sexual function in women with uterovaginal prolapse and urinary incontinence. Obstet Gynecol. 1995;85:483–7.CrossRefPubMedGoogle Scholar
  23. 23.
    Oh SJ, Choo MS, Kim HS, Kim JC, Lee JG, Yun JM, et al. Generic and disease-specific health-related quality of life in women with coital incontinence: a prospective, multicenter study. Gynecol Obstet Investig. 2007;65(1):62–7.CrossRefGoogle Scholar
  24. 24.
    Roos AM, Thakar R, Sultan AH, Burger CW, Paulus AT. Pelvic floor dysfunction: women’s sexual concerns unraveled. J Sex Med. 2014;11(3):743–52.CrossRefPubMedGoogle Scholar
  25. 25.
    Field SM, Hilton P. The prevalence of sexual problems in women attending for urodynamic investigation. Int Urogynecol J. 1993;4(4):212–5.CrossRefGoogle Scholar
  26. 26.
    Bachman JW. The patient-computer interview: a neglected tool that can aid the clinician. Mayo Clin Proc. 2003;78:67–78.CrossRefPubMedGoogle Scholar
  27. 27.
    Jha S, Moran P, Greenham H, Ford C. Sexual function following surgery for urodynamic stress incontinence. Int Urogynecol J Pelvic Floor Dysfunct. 2007;18(8):845–50.CrossRefPubMedGoogle Scholar
  28. 28.
    Glavind K, Larsen T, Lindquist ASI. Sexual function in women before and after tension-free vaginal tape operation for stress urinary incontinence. Acta Obstet Gynecol Scand. 2014;93:986–90.CrossRefPubMedGoogle Scholar
  29. 29.
    Lindquist AS, Glavind K. Long-term follow-up of sexual function in women before and after tension-free vaginal tape operation for stress urinary incontinence. Int Urogynecol J. 2016;27(10):1571–6. doi: 10.1007/s00192-016-3004-x.CrossRefPubMedGoogle Scholar
  30. 30.
    Mommsen S, Foldspang A. Body mass index and adult female urinary incontinence. World J Urol. 1994;12(6):319–22.CrossRefPubMedGoogle Scholar

Copyright information

© The International Urogynecological Association 2017

Authors and Affiliations

  • Thomas Gray
    • 1
    Email author
  • Weiguang Li
    • 2
  • Patrick Campbell
    • 3
  • Swati Jha
    • 1
  • Stephen Radley
    • 1
  1. 1.Department of UrogynaecologySheffield Teaching Hospitals NHS Foundation TrustSheffieldUK
  2. 2.University of Sheffield Medical SchoolSheffieldUK
  3. 3.Belfast City HospitalBelfastUK

Personalised recommendations