Introduction and hypothesis
To explore the effect of urologic chronic pelvic pain syndrome (UCPPS) on female sexual function.
Database searches were conducted in PubMed, EMBASE, the Cochrane Library, and Google Scholar for published literature using the Female Sexual Function Index (FSFI) or reporting the prevalence of dyspareunia. Data extraction and quality evaluation were performed on the literature that met the inclusion criteria, and a meta-analysis was performed using STATA 12.0 and RevMan5.3 software to calculate the mean differences (MD) and odds ratios (OR) and their 95% confidence intervals (CI).
A total of nine case-control studies enrolling 4965 subjects were investigated. The present meta-analysis results demonstrated a strong correlation between UCPPS and dyspareunia (OR = 11.27, 95% CI: 5.15–24.67, P < 0.00001). The UCPPS group had significantly lower scores in each domain of the FSFI compared with the healthy control group: total score (MD = −11.35, 95% CI: −14.54– − 8.16, P < 0.00001); desire (MD = −1.04, 95% CI: −1.20– − 0.88, P < 0.00001); arousal (MD = −1.78, 95% CI: −2.36– − 1.20, P < 0.00001); lubrication (MD = −2.11, 95% CI: −2.49– − 1.73, P < 0.00001); orgasm (MD = −1.50, 95% CI: −1.72– − 1.28, P < 0.00001); satisfaction (MD = −1.54, 95% CI: −1.97– − 1.12, P < 0.00001); pain (MD = −2.89, 95% CI: −3.63– − 2.14, P < 0.00001).
UCPPS had a significantly negative effect on female sexual function, particularly in the lubrication, pain, and total score domains. In addition, UCPPS patients had a significantly higher risk of dyspareunia. Psychosocial variables may be a potential pathogenesis of female sexual dysfunction (FSD). Future well-designed research is called for to develop a comprehensive estimate of the association between UCPPS and FSD.
This is a preview of subscription content, log in to check access.
Buy single article
Instant access to the full article PDF.
Tax calculation will be finalised during checkout.
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
Tax calculation will be finalised during checkout.
Landis JR, Williams DA, Lucia MS, Clauw DJ, Naliboff BD, Robinson NA, et al. The MAPP research network: design, patient characterization and operations. BMC Urol. 2014;14:58. https://doi.org/10.1186/1471-2490-14-58.
Rosen R, Brown C, Heiman J, Leiblum S, Meston C, Shabsigh R, et al. The female sexual function index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital Ther. 2000;26(2):191–208. https://doi.org/10.1080/009262300278597.
Wiegel M, Meston C, Rosen R. The female sexual function index (FSFI): cross-validation and development of clinical cutoff scores. J Sex Marital Ther. 2005;31(1):1–20. https://doi.org/10.1080/00926230590475206.
Stroup DF, Berlin JA, Morton SC, Olkin I, Williamson GD, Rennie D, et al. Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis of observational studies in epidemiology (MOOSE) group. JAMA. 2000;283(15):2008–12.
Wells G, Shea B, O’Connell D, Peterson J, Welch V, Losos M, et al. The Newcastle-Ottawa scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. 2017. http://www.ohrica/programs/clinical_epidemiology/oxford.asp.
Gardella B, Porru D, Nappi RE, Dacco MD, Chiesa A, Spinillo A. Interstitial cystitis is associated with vulvodynia and sexual dysfunction—a case-control study. J Sex Med. 2011;8(6):1726–34. https://doi.org/10.1111/j.1743-6109.2011.02251.x.
Gardella B, Porru D, Ferdeghini F, Martinotti Gabellotti E, Nappi RE, Rovereto B, et al. Insight into urogynecologic features of women with interstitial cystitis/painful bladder syndrome. Eur Urol. 2008;54(5):1145–53. https://doi.org/10.1016/j.eururo.2008.01.079.
Nickel JC, Tripp DA, Pontari M, Moldwin R, Mayer R, Carr LK, et al. Psychosocial phenotyping in women with interstitial cystitis/painful bladder syndrome: a case control study. J Urol. 2010;183(1):167–72. https://doi.org/10.1016/j.juro.2009.08.133.
Warren JW, Clauw DJ, Wesselmann U, Langenberg PW, Howard FM, Morozov V. Sexuality and reproductive risk factors for interstitial cystitis/painful bladder syndrome in women. Urology. 2011;77(3):570–5. https://doi.org/10.1016/j.urology.2010.10.018.
Zaslau S, Riggs DR, Perlmutter AE, Jackson BJ, Osborne J, Kandzari SJ. Sexual dysfunction in patients with painful bladder syndrome is age related and progressive. Can J Urol. 2008;15(4):4158–62.
Zondervan KT, Yudkin PL, Vessey MP, Jenkinson CP, Dawes MG, Barlow DH, et al. Chronic pelvic pain in the community—symptoms, investigations, and diagnoses. Am J Obstet Gynecol. 2001;184(6):1149–55. https://doi.org/10.1067/mob.2001.112904.
Ottem DP, Carr LK, Perks AE, Lee P, Teichman JM. Interstitial cystitis and female sexual dysfunction. Urology. 2007;69(4):608–10. https://doi.org/10.1016/j.urology.2006.12.024.
Peters KM, Killinger KA, Carrico DJ, Ibrahim IA, Diokno AC, Graziottin A. Sexual function and sexual distress in women with interstitial cystitis: a case-control study. Urology. 2007;70(3):543–7. https://doi.org/10.1016/j.urology.2007.04.037.
Schrepf A, O'Donnell M, Luo Y, Bradley CS, Kreder K, Lutgendorf S. Inflammation and inflammatory control in interstitial cystitis/bladder pain syndrome: associations with painful symptoms. Pain. 2014;155(9):1755–61. https://doi.org/10.1016/j.pain.2014.05.029.
Yoon HS, Yoon H. Correlations of interstitial cystitis/painful bladder syndrome with female sexual activity. Korean J Urol. 2010;51(1):45–9. https://doi.org/10.4111/kju.2010.51.1.45.
Lee M-H, Chen W-C, Chiu C-D, Wu H-C. Dyspareunia and chronic pelvic pain in patients with interstitial cystitis/bladder pain syndrome. Urol Sci. 2015;26(3):206–9. https://doi.org/10.1016/j.urols.2015.07.004.
Nickel JC, Parsons CL, Forrest J, Kaufman D, Evans R, Chen A, et al. Improvement in sexual functioning in patients with interstitial cystitis/painful bladder syndrome. J Sex Med. 2008;5(2):394–9. https://doi.org/10.1111/j.1743-6109.2007.00686.x.
Aaron LA, Herrell R, Ashton S, Belcourt M, Schmaling K, Goldberg J, et al. Comorbid clinical conditions in chronic fatigue: a co-twin control study. J Gen Intern Med. 2001;16(1):24–31.
Heitkemper M, Jarrett M. Overlapping conditions in women with irritable bowel syndrome. Urol Nurs. 2005;25(1):25–30 quiz 31.
Kaya S, Hermans L, Willems T, Roussel N, Meeus M. Central sensitization in urogynecological chronic pelvic pain: a systematic literature review. Pain Physician. 2013;16(4):291–308.
Lai HH, Gardner V, Ness TJ, RWt G. Segmental hyperalgesia to mechanical stimulus in interstitial cystitis/bladder pain syndrome: evidence of central sensitization. J Urol. 2014;191(5):1294–9. https://doi.org/10.1016/j.juro.2013.11.099.
Woolf CJ. Central sensitization: implications for the diagnosis and treatment of pain. Pain. 2011;152(3 Suppl):S2–15. https://doi.org/10.1016/j.pain.2010.09.030.
Fall M, Baranowski AP, Elneil S, Engeler D, Hughes J, Messelink EJ, et al. EAU guidelines on chronic pelvic pain. Eur Urol. 2010;57(1):35–48. https://doi.org/10.1016/j.eururo.2009.08.020.
Rodriguez MA, Afari N, Buchwald DS. Evidence for overlap between urological and nonurological unexplained clinical conditions. J Urol. 2009;182(5):2123–31. https://doi.org/10.1016/j.juro.2009.07.036.
Nickel JC, Shoskes D, Irvine-Bird K. Clinical phenotyping of women with interstitial cystitis/painful bladder syndrome: a key to classification and potentially improved management. J Urol. 2009;182(1):155–60. https://doi.org/10.1016/j.juro.2009.02.122.
Tonyali S, Yilmaz M. Sexual dysfunction in interstitial cystitis. Curr Urol. 2017;11(1):1–3. https://doi.org/10.1159/000447186.
Clemens JQ, Mullins C, Kusek JW, Kirkali Z, Mayer EA, Rodriguez LV, et al. The MAPP research network: a novel study of urologic chronic pelvic pain syndromes. BMC Urol. 2014;14:57. https://doi.org/10.1186/1471-2490-14-57.
Engeler DS, Baranowski AP, Dinis-Oliveira P, Elneil S, Hughes J, Messelink EJ, et al. The 2013 EAU guidelines on chronic pelvic pain: is management of chronic pelvic pain a habit, a philosophy, or a science? 10 years of development. Eur Urol. 2013;64(3):431–9. https://doi.org/10.1016/j.eururo.2013.04.035.
van de Merwe JP, Nordling J, Bouchelouche P, Bouchelouche K, Cervigni M, Daha LK, et al. Diagnostic criteria, classification, and nomenclature for painful bladder syndrome/interstitial cystitis: an ESSIC proposal. Eur Urol. 2008;53(1):60–7. https://doi.org/10.1016/j.eururo.2007.09.019.
Lo CK, Mertz D, Loeb M. Newcastle-Ottawa scale: comparing reviewers’ to authors’ assessments. BMC Med Res Methodol. 2014;14:45. https://doi.org/10.1186/1471-2288-14-45.
We thank Prof. Zhihai Qin for his linguistic assistance and suggestions to improve the manuscript. We thank Prof. Hairong Huang for her assistance with the statistical aspects.
This study was funded by grants from the Natural Science Foundation of Hainan Province (no. 20158296).
Conflicts of interest
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
About this article
Cite this article
Guan, Y., Yu, G., Wang, G. et al. The negative effect of urologic chronic pelvic pain syndrome on female sexual function: a systematic review and meta-analysis. Int Urogynecol J 30, 1807–1816 (2019). https://doi.org/10.1007/s00192-019-03984-z
- Urologic chronic pelvic pain syndrome
- Female sexual dysfunction
- Female Sexual Function Index