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Sexualité et incontinence urinaire de la femme

Sexual function in women with urinary incontinence

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Pelvi-périnéologie

Résumé

L’incontinence urinaire est souvent associée à une dysfonction sexuelle. Les mécanismes physiopathologiques sont souvent identiques : âge, prolapsus, ménopause, hystérectomie, chirurgie abdominale ou périnéale antérieure. La neuropathie d’étirement avec dénervation du plancher périnéal peut déterminer incontinence et troubles sexuels tels qu’une anorgasmie. Les fuites percoïtales peuvent être dues à une hyperpression abdominale, à une instabilité urétrale ou à un réflexe spinal par stimulation périnéale cutanée induisant des contractions non inhibées du détrusor. Les facteurs psychologiques devant toujours être appréhendés tant sur le plan diagnostique que thérapeutique.

Abstract

Urinary incontinence is often associated with sexual dysfunction. Pathophysiological mechanisms are identical: age, which is the most important predictor of sexual dysfunction, prolapse, menopause, hysterectomy, and previous abdominal or perineal surgery. Perineal stretch neuropathy with progressive denervation of striated pelvic sphincter musculature due to repeated stretch injury of perineal innervation can determine stress urinary incontinence and sexual disorders (anorgasmia). Urinary incontinence during sexual intercourse is due to increased abdominal pressure, urethral instability, or perineal skin stimulation inducing spinal reflex leading to uninhibited detrusor contraction. Psychogenic factors may be always considered in diagnosis and treatment.

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Authors and Affiliations

  1. Service de rééducation neurologique et d’explorations périnéales, hôpital Rothschild, 33, boulevard de Picpus, 75571, Paris cedex 12, France

    G. Amarenco, P. Lacroix, M.-A. Delille, D. Verollet & M. Jousse

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  1. G. Amarenco
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  2. P. Lacroix
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  3. M.-A. Delille
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  4. D. Verollet
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  5. M. Jousse
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Correspondence to G. Amarenco.

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Amarenco, G., Lacroix, P., Delille, MA. et al. Sexualité et incontinence urinaire de la femme. Pelv Perineol 5, 97–101 (2010). https://doi.org/10.1007/s11608-010-0318-x

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  • DOI: https://doi.org/10.1007/s11608-010-0318-x

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