Archive | 2021
Lower urinary tract symptoms in pre-menopausal women and its association with sexual dysfunction
Abstract
Copyright (c) 2021 Asian Journal of Medical Sciences This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. Mishra, et al.: Lower urinary tract symptoms in pre-menopausal women Asian Journal of Medical Sciences | Aug 2021 | Vol 12 | Issue 8 95 rare and distressing, 6) orgasmic disorder, 7) vaginismus, and 8) dyspareunia.3 The global study of sexual attitudes and behaviours, a multinational survey which involved 13,882 women in aged between 40 and 80 years, reported that lack of interest in sex with difficulty in reaching orgasm were the most common SDs across the world regions, whose incidence ranging between 26% to 48% and 18% to 41%, respectively.5 However, SD is more commonly observed in the premenopausal women and frequently exist along with the lower urinary tract symptoms (LUTS).6,7 Lower urinary tract symptoms usually observed in the form of stress urinary incontinence (SUI), urge urinary incontinence (UUI), mixed urinary incontinence (MUI) or overactive bladder (OAB) with or without urinary continence.7 Urinary incontinence and SD are associated w ith each other most of the time. But mostly these remains neglected and untreated.6,8,9 Prevalence and the association of SD with LUTS remains uncertain in majority of the population. Therefore, the present study was planned to know about any association between LUTS and sexual problems in pre-menopausal women. MATERIALS AND METHODS The present prospective observational study was initiated after obtaining Institutional Ethics Committee approval and was conducted from March 2018 to February 2019 at the Department of Urology, IGIMS, Patna, Bihar India. A total of 105 sexually active premenopausal women who presented with the complain of any of LUTS attending outdoor patient department or admitted in urology department were included in the study. Informed consent was obtained from all the included patients. Proper history helps in identification of various co-morbidities and other medical conditions. Lifestyle habits, any medications intake in the past, emotional and psychological factors also asked. The presence of lifestyle factors like obesity and addiction, medical conditions like diabetes, depression and partner status were also assessed. After proper history taking and physical examination each and every patient were given two questionnaires. One was Bristol Female Lower Urinary Tract Symptom (BFLUTS) questionnaire for the assessment of LUTS and another was the Pelvic Organ Prolapse-Urinary Incontinence Sexual Function Questionnaire (PISQ-12) for the assessment of their sexual function. BFLUTS questionnaire consists of 19 questions on filling symptoms, voiding symptoms and incontinence symptoms and PISQ-12 covers behaviouralemotive, physical and partner-related questions. The filling symptoms of LUTS includes nocturia, rush to toilet (urgency), bladder pain and frequency (≤3h between voiding). Voiding symptoms are hesitancy (delay to start urinate), strain to urinate and intermittency (stop and start more than once). Incontinence symptoms are leaking before getting to toilet (urge incontinence), frequency of incontinence, stress incontinence (when physically active, cough etc.), unpredictable incontinence (no reason and feeling) and nocturnal incontinence (leaking when asleep). Lack of sexual desire, orgasm, sexual excitement and satisfaction from the sexual activity, pain during sexual intercourse are domains which assessed and recorded. All details regarding the patients’ demographics, scoring and results were entered into the patient record form. STATISTICAL ANALYSIS All data were recorded in a proforma specially designed for the study. The data collected was stored in Microsoft excel 2007 © Microsoft office. Data collected on 105 cases were scrutinized, coded and entered into IBM SPSS 16.0 statistics, Statistical analysis was done by IBM SPSS 16.0 statistics. Chi-square test of independence and one-way analysis of variance (ANOVA) used as a test of significance for outcome analysis. The cut off value of ‘p’ for test of significance was taken as <0.05. Multivariate regression analysis was performed using logistic regression for these variables.