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Sexual function in women with anal incontinence using a new instrument: the PISQ-IR

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Abstract

Introduction

Anal incontinence (AI) has been associated with sexual complaints. The Pelvic Organ Prolapse/Incontinence Sexual Questionnaire-IUGA Revised (PISQ-IR) has been validated to measure sexual function in sexually active (SA) and non-SA (NSA) women with pelvic floor disorders (PFD) including AI. We describe symptoms in women with PFDs including AI using this instrument.

Methods

This was a planned secondary analysis of data collected for the validation of the PISQ-IR. SA and NSA women with symptoms of pelvic organ prolapse, urinary incontinence (UI) and/or AI at 12 US and 5 UK sites were recruited. The Female Sexual Function Index (FSFI) and PISQ-IR were completed in addition to the Pelvic Floor Distress Inventory (PFDI), and other measures.

Results

Of 872 women enrolled, 90 (10 %) reported AI. Compared with women without AI, women with AI were more likely to report stress UI (p = 0.007), urgency UI (p < 0.001), mixed UI (p < 0.001), diabetes (p = 0.036) and depression (p < 0.001), and to show larger genital hiatus measurements (p = 0.005) and more underactive pelvic floor muscles (p = 0.011). Furthermore, scores on the PFDI showed greater bother (p = 0.013), particularly the colorectal subscale (p < 0.001). While sexual activity was similar between the groups, FSFI desire (p = 0.016), PISQ-IR ‘condition-specific’ (p = 0.03) and ‘global quality’ (p = 0.046) domains were worse in women with AI. In logistic regression analysis, only the PISQ-IR ‘condition-specific’ domain was associated with AI when controlling for other confounders (OR 0.27, 95 % CI 0.10 – 0.72, p = 0.009).

Conclusions

Women with AI have similar rates of sexual activity but poorer sexual function than women without AI. The PISQ-IR may be most appropriate to characterize these conditions.

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Acknowledgements

The authors wish to acknowledge Angela Fellner, PhD, and Janine Benbouajili, MA, for their assistance with data analysis and Vivian Ghodsi, RN, for her involvement in recruitment.

Conflicts of interest

Rebecca Rogers is DSMB chair for the TRANSFORM trial sponsored by American Medical Systems and receives royalties from UptoDate and McGraw Hill. She is an Associate Editor for the International Urogynecology Journal.

Mitesh Parekh is a speaker for Astellas and consultant for Boston Scientific..

Peter Sand is a consultant or receives royalties from Boston Scientific, Ferring, Allergan, Cook Myosite, Astellas, Actavis, Hologic and AlltheRx.

Joan Pitkin receives honoraria and holds a position with the Northwest Hospitals NHS Trust.

Dorothy Kammerer-Doak and Rachel Pauls have have no financial conflicts of interest to disclose.

Author information

Authors and Affiliations

  1. Division of Female Pelvic Medicine and Reconstructive Surgery, TriHealth Good Samaritan Hospital, 3219 Clifton Ave, Suite 100, Cincinnati, OH, 45220, USA

    Rachel N. Pauls

  2. Department of Obstetrics and Gynecology, University of New Mexico, Albuquerque, NM, USA

    Rebecca G. Rogers

  3. Urogynecology, Genesis Health System, Zanesville, OH, USA

    Mitesh Parekh

  4. Department of Gynaecology, Imperial College, Northwest London Hospitals NHS Trust, London, UK

    Joan Pitkin

  5. Women’s Pelvic Specialty Care, University of New Mexico Hospital, Albuquerque, NM, USA

    Dorothy Kammerer-Doak

  6. Evanston Continence Center, NorthShore University HealthSystem, University of Chicago, Pritzker School of Medicine, Chicago, IL, USA

    Peter Sand

Authors
  1. Rachel N. Pauls
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  2. Rebecca G. Rogers
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  3. Mitesh Parekh
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  4. Joan Pitkin
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  5. Dorothy Kammerer-Doak
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  6. Peter Sand
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Corresponding author

Correspondence to Rachel N. Pauls.

Additional information

The original study was made possible through funding from the International Urogynecological Association (IUGA).

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Pauls, R.N., Rogers, R.G., Parekh, M. et al. Sexual function in women with anal incontinence using a new instrument: the PISQ-IR. Int Urogynecol J 26, 657–663 (2015). https://doi.org/10.1007/s00192-014-2563-y

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  • DOI: https://doi.org/10.1007/s00192-014-2563-y

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