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Objective: The aim of this study was to evaluate the relationship between body mass index (BMI) and female sexual dysfunction (FSD) among perimenopausal and postmenopausal women with urinary incontinence (UI)., Methods: From 2005 to 2008, we enrolled 208 consecutive women affected by UI; all underwent a comprehensive history including two validated questionnaires, physical examination, and urodynamic evaluation. Based on BMI, participants were grouped into normal weight, overweight, and obese., Results: A total of 158 participants completed both questionnaires (76% response rate); 41 (26%) were normal weight, 73 (46%) were overweight, and 44 (28%) were obese. The increasing Urogenital Distress Inventory score had a direct correlation with age (P < 0.01), year of menopause onset (P < 0.05), and BMI (P < 0.01). FSD was diagnosed in 97 women (61%): 31 (32%) with hypoactive sexual desire, 20 (21%) with sexual arousal disorder, 7 (7%) with orgasmic deficiency, and 39 (40%) with sexual pain disorder. BMI greater than 30 kg/m was independently associated with an increased risk of FSD (odds ratio [OR], 2.02) and UI (OR, 2.03). With adjustment for BMI, the OR for FSD was 1.22 for overweight women and 1.56 for obese women, with respect to healthy participants. The total Female Sexual Function Index score correlated with BMI (r = -0.82, P = 0.0001); in particular, arousal (r = -0.82), orgasm (r = -0.72), lubrication (r = -0.61), and satisfaction (r = -0.63, all P < 0.001) showed an inverse correlation with BMI, whereas desire and pain did not., Conclusions: Increased BMI early in menopause represents a risk both for UI and for sexual dysfunction. Weight control has an essential role in postmenopause and should be considered early in perimenopause to safeguard female quality of life as well as to prevent or improve UI and female sexual dysfunction symptoms.

Introduction: Women's sexual dysfunctions (WSD) have been commonly associated with urinary incontinence (UI). Women with UI and who scored low on the Female Sexual Function Index (FSFI) showed an improvement in urinary leakage and also in their sexual life following treatment by transvaginal electrical stimulation (TES)., Aims: To determine the effects of TES in 37 women complaining of UI, of whom 23 also had WSD, and to compare the FSFI scores of women with UI and 43 women not affected by UI who underwent routine urologic evaluation., Methods: Thirty-seven women complaining of UI were evaluated by voiding diary and with FSFI before and after 3 months of TES. All had a urogynecologic evaluation and urodynamic study., Main Outcome Measures: In the voiding diary the women reported the types of liquid they ingested, urinary frequency, and episodes of urgency and urine leakage. The domain scores of the FSFI, including desire, arousal, lubrication, orgasm, satisfaction, and pain, were calculated. TES was conducted for 15-30 minutes, twice a week for 3 months, using biphasic intermittent current with a frequency of 50 Hz for stress UI (SUI) and 20 Hz for urge UI (UUI), and the most tolerable intensity of stimulation., Results: After TES, only two of the 10 women with UUI experienced a few leakage incidents; patients with SUI were completely dry during TES; and only three reported a few episodes of UI during intense activities. The five patients with mixed UI improved mainly as regards urgency. The FSFI scores of patients complaining of UI showed significantly lower desire and sexual satisfaction, and higher sexual pain than controls. After 3 months, the 23 women affected by WSD, of the 37 participants with UI, reported a remarkable improvement in their sexual life., Conclusions: TES was found to be a safe and effective therapy for selected patients affected by mild to moderate UI. Because women with UI also complain of WSD compared with the general female population, an investigation of female sexuality is suggested for these patients.

Introduction: Pelvic floor muscle training (PFMT) and electrical stimulation (ES) are conservative models of therapy for treating female stress urinary incontinence (SUI). The presence of estradiol receptors in the lower urinary tract advances the case for estradiol therapy in SUI. The aim of our study was to investigate the effects of the combination of pelvic floor rehabilitation and intravaginal estriol (IE) on SUI treatment in postmenopausal women. Material and Methods: Sixty-two women with SUI were randomized to PFMT, ES and biofeedback (Group 1) or the same treatment plus 1 mg IE (Group 2) for 6 months. Patients were evaluated with medical history, pelvic examination, urodynamics, 24-hour pad test. Urinary incontinence was evaluated using the International Consultation on Incontinence questionnaire on urinary incontinence short form and quality of life using the Incontinence Impact Questionnaire-Short Form. Results: Two patients were lost at follow-up and one discontinued the study. Mean urine leakage at the 24-hour pad test dropped from 42.3 ± 20.2 g/die to 31.5 ± 14.2 g/die in Group 1 and from 48.3 ± 19.8 g/die to 22.3 ± 10.1 g/die in Group 2. Symptoms scores and incontinence status were statistically significant better in Group 2 when compared to Group 1. Conclusion: IE added to PFMT, ES and BF is a safe and efficacious first-line therapy in postmenopausal women with SUI. © 2015 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Introduction. Significantly more women reporting stress urinary incontinence (SUI) or low urinary tract symptoms complained of sexual dysfunction than a general healthy female population. The use of a tension-free vaginal tape (TVT), placed transvaginally under the mid-urethra, ensures to reacquire continence but could affect sexual function. Aim. This study aimed to determine if a suburethral tape for the correction of SUI could interfere with sexual activity. Methods. Of 108 patients, 37 underwent positioning of a tension free vaginal tape through a retropubic approach (TVT), and 71 through a transobturator approach from outside to inside (TOT). Main Outcome Measures. All patients enrolled had a complete urodynamic study and were invited to answer the Female Sexual Function Index questionnaire and our personal questionnaire, before surgery, after 1 month, and then at 3-month intervals. Results. Of the 108 patients, 67% of the women experienced incontinence during intercourse, 96% during penetration, and 4% on orgasm. The cure rate for SUI was 97.1%. Sixty-two women (87%) with TOT placement and 31 (84%) with TVT were satisfied with the operation as regards sexual function, 68 (96%) and 29 (78%), respectively, with TOT and TVT had an improvement of urinary symptoms with resolution of urinary leakage during intercourse, after a 12.3-month follow-up. Just one patient treated with a TOT approach and two with the TVT complained of low grade of leakage. Of the 101 sexually active women, 90.1% reported a significant improvement in their sexual life, 9.9% referred a poor sexual activity not due to surgical intervention. Conclusions. In the surgical treatment of SUI, it is important to think about the patients' future sexual life and inform them that the great part of women can expect to improve their quality of life. Pace G, and Vicentini C. Female sexual function evaluation of the tension-free vaginal tape (TVT) and transobturator suburethral tape (TOT) incontinence surgery: Results of a prospective study. J Sex Med 2008;5:387–393. [ABSTRACT FROM AUTHOR]

INTRODUCTION. Overactive Bladder (OAB) and Urge Urinary Incontinence (UUI) are both debilitating and bothersome conditions. OAB negatively impact on women's quality of life affecting their own ability and personal relationships. Our aim has been to evaluate how OAB and UUI affect women's sexual function and the possible role of antimuscarinic drugs in improving their sexual condition. MATERIALS AND METHODS. From January 2009 to May 2010, 58 women diagnosed with OAB filled in the self-administered questionnaires: Female Sexual Function Index (FSFI), the short form of Urogenital Distress Inventory (UDI-6) and the Incontinence Impact Questionnaire (IIQ-7). 33 of them (57%) reported a FSFI score<26,55 and were treated with Solifenacin 5mg. they were re-evaluated with the same questionnaires after three months of therapy. RESULTS. The mean FSFI score of 33 patients affected by Female Sexual Disfunction (FSD) was 21,8 (range: 18,6-25,7). The six domains designed to address different aspects of female sexual dysfunctions, sexual desire, satisfaction, orgasm, arousal, lubrication and related pain symptoms, were altered in 48, 33, 21, 15, 12 and 8% of the patients respectively. In 70% of the patients, FSFI score improved of a mean of 5,4 after three months of therapy; UDI-6 and IIQ-7 decreased from 56,3 and 59,9 to 47,6 and 50,2, respectively. Considering women with UUI + OAB or OAB alone, we reported a significant improvement of urinary symptoms and women sexual condition after three months of therapy. CONCLUSION. OAB syndrome was found to cause greater deterioration in women sexual function. Antimuscarinic drugs are the mainstay of pharmacologic treatment of OAB able to improve urinary symptoms, enhance quality of life and female sexual condition. [ABSTRACT FROM AUTHOR]