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Overactive Bladder
noted in a qualitative study examining the effect of urinary leakage Coyne et al. also noted that the effects of OAB extended beyond the
during sexual intercourse that 44% of women reported an adverse bedroom and affected emotional wellbeing, self-esteem and personal
effect on their sex life.
16
relationships. The majority of women were embarrassed by their
incontinence and OAB, with a resulting loss of self-image and self-
Overactive Bladder and Sexual Health confidence. Additionally, more than 80% of the continent women
Although sexual function is a component of sexual health, sexual indicated that their bladder symptoms affected their relationship with
health is much broader in that it also includes such aspects as their partner or spouse, causing lost intimacy, which contributed to
emotional wellbeing, social interaction – especially with a partner – relationship strain. OAB with incontinence was a particular burden for
self-image, self-confidence and satisfaction. However, there is a women not currently in a relationship as there was a tremendous
dearth of studies exploring this broader issue of sexual health or sexual reluctance among the single participants to begin a sexual relationship.
9
quality of life.
Although the women considered these issues to be quite serious, one-
An Internet-based study assessed the impact of OAB and UI on the sexual third of the participants did not feel comfortable discussing the subject
activity and sexual quality of life in Korean women between 20 and 49 with their healthcare providers. Both continent and incontinent
years of age and reported that sexual activity was significantly reduced in women with OAB reported that they felt that the topic of sexual health
the OAB and UI groups versus the control group, with OAB causing is avoided in the primary care setting and is only rarely discussed
greater negative impact on sexual quality of life than UI.
23
among specialists.
9
A recent qualitative study was conducted in women with OAB to Conclusion
determine the extent to which OAB impacts their sexual health. Thirty- The impact of OAB and UI extends beyond simply the physical
four women with OAB (11 continent, 23 incontinent) participated in manifestation of symptoms and general life impact. For women
focus group discussions followed by administration of the Sexual Quality with OAB, whether continent or incontinent, their sexual health is
of Life Questionnaire for Females (SQoL-F).
9
Women in the study also impacted. There is evidence of lower levels of desire, arousal,
reported that OAB affected their sexual health in a variety of ways. lubrication and orgasms, and some evidence of increased pain with
Continent women tended to have retained their sexual desire, despite intercourse (among continent women). The fear of urine loss
the fact that pain, frequency and urgency reduced their enjoyment. On during sex also reduces sexual satisfaction. While the impact on
the other hand, around half of the incontinent women reported a sexual health is slightly greater for women with incontinence than
decrease in sexual desire. Arousal and orgasm were adversely affected in those who are continent, OAB impairs many aspects of a woman’s
both groups, typically owing to fear and anxiety about needing to void sex life, with detrimental effects on personal feelings and inter-
and/or leaking during sex. More of the continent women than the personal relationships.
incontinent women were frustrated with their sex life and found it
“limiting and frustrating”. Within the continent group, although sexual There is a pressing need for healthcare providers to address this issue
desire was maintained, many expressed frustration with pain or with their patients, as many women are reluctant to bring up the issue
discomfort during intercourse, which was further highlighted by their independently. A woman’s sexual health is an important aspect of her
low scores on the SQoL-F. Patel et al. also noted reports of pain during life and affects not only her sexual relationship, but also life in general.
intercourse in 43% of women with OAB, although they did not Given the prevalence of OAB in the general population, this is an area
differentiate between continent and incontinent OAB women.
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that deserves more attention. ■
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68 EUROPEAN GENITO-URINARY DISEASE 2007
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