Sexual Function in Postmenopausal Women with Urinary Incontinence and Pelvic Organ Prolapse
Year 2024,
Issue: 4, 17 - 25, 29.02.2024
Merve Tuncer
,
Ümran Oskay
,
Özlem Öner
Abstract
Objective: This study aims to investigate the frequency of pelvic organ prolapse and urinary incontinence and their effects on sexual function.
Material and Method: This descriptive and cross-sectional study included 605 women in their climacteric period who were admitted to a hospital in Istanbul, between April 2018 and January 2019. The data was collected by a structured questionnaire form with 37 questions and pelvic organ prolapse/urinary incontinence sexual function questionnaire scale (PISQ-12).
Results: The incidence of urinary incontinence (43.1%) and pelvic organ prolapse (protrusion 24.3%; bulging 16.4%) was noticeably high in postmenopausal women. The mean score of PISQ-12 was 29.43 ± 3.51. The women with urinary incontinence (p=0.008) and pelvic organ prolapse (p=0.000) had lower PISQ-12 scores in comparison to those without urinary incontinence and pelvic organ prolapse.
Conclusion: The incidence of urinary incontinence and pelvic organ prolapse was noticeably high in postmenopausal women. The women with urinary incontinence and pelvic organ prolapse had lower sexual function scores.
References
- 1. Farrell E. Genitourinary syndrome of menopause. RCOG. 2017;46(7):481-4. google scholar
- 2. Mitchell CM, Reed SD, Diem S, et al. Efficacy of vaginal estradiol or vaginal moisturizer vs placebo for treating postmenopausal vulvovaginal symptoms: A randomized clinical trial. JAMA Internal Medicine. 2018;178(5): 681-90. doi: 10.1001/ jamainternmed.2018.0116. google scholar
- 3. Jennifer MW, Hundley AF, Fulton RG, et al. Forecasting the prevalence of pelvic floor disorders in U.S. women. Obstet Gynecol. 2009;114(6): 1278-83. doi: 10.1097/ AOG.0b013e3181c2ce96. google scholar
- 4. Dellü MC, Schmitt ACB, Cardoso MRA, et al. Prevalence and factors associated with urinary incontinence in climacteric. Rev Assoc Med Bras. 2016;62(5):441-6. doi: 10.4103/ijcm. IJCM_29_19 google scholar
- 5. Topuz Ş. Urinary incontinence and sexuality. Balıkesir J Health Sci. 2015;4(1): 60-4. google scholar
- 6. Gupta N, Aggarwal M, Sinha R, et al. Study on prevalence and severity of urogenital complaints in postmenopausal women at a tertiary care hospital. J Mid Health. 2018;9:130-4. doi: 10.4103/jmh.JMH_91_17 google scholar
- 7. Yeşiltepe Oskay U, Kızılkaya Beji N, Yalçın O. A study on urogenital complaints of postmenopausal women aged 50 and over. Acta Obstet Gynecol Scand. 2005;84: 72-8. google scholar
- 8. Grzybowska MR, Wydra DG. Coital incontinence: a factor for deteriorated health-related quality of life and sexual function in women with urodynamic stress urinary incontinence. Int Urogynecol J. 2017;28: 697-704. doi: 10.1007/s00192-016-3185-3. google scholar
- 9. Santoro N, Epperson N, Mathews SB. Menopausal symptoms and their management. Endocrinology and Metabolism Clinics of North America. 2015;44(3): 497-515. doi: 10.1016/j. ecl.2015.05.001 google scholar
- 10. Kılıç M, Ejder Apay S, Kızılkaya Beji N. Sexual function disorders and nursing approach due to pelvic organ prolapse. I.U.F.N. Journal of Nursing.2011;19(3): 194-202. google scholar
- 11. Cam Ç, Sancak P, Karahan N, et al. Validation of the short form of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) in a Turkish population. European J Obstet Gynecology and Reproductive Bio. 2009;146: 104-7. doi: 10.1016/j.ejogrb.2009.05.016. google scholar
- 12. Hoga LAK, Rodolpho JRC, Gonçalves BG, Quirino B. Women’s experiences of menopause: A systematic review protocol of qualitative evidence. JBI Database System Rev Implement Rep. 2014;12(7): 72 - 81. doi: 10.11124/jbisrir-2015-1948. google scholar
- 13. Sis Çelik A, Pasinlioğlu T. The symptoms of climacteric period and the role of the nurse. Erciyes University Faculty of Health Scien J. 2013;1(1): 48-56. google scholar
- 14. Jha S, Gopinath D. Prolapse or incontinence: what affects sexual function the most? Int Urogynecol J. 2016;27: 607-611. doi: 10.1007/s00192-015-2887 google scholar
- 15. Güdücü N, Özcan Keser N. Evaluation of sexual functions of women with urinary incontinence. J Academic Res in Nursing. 2016;2(1):16-23. google scholar
- 16. Şentürk S, Kara M. Risk factors and prevalence of urinary incontinence in postmenopausal women living in Turkey. Clinical and Experimental Obstetrics & Gynecology 2011;69-71. google scholar
- 17. Şensoy N, Doğan N, Özek B, Karaaslan L. Urinary incontinence in women: prevalence rates, risk factors and impact on quality of life. Pakistan Journal of Medical Sciences. 2013;29(3): 818-22. google scholar
- 18. Cerruto MA, D’Elia C, Aloisi A, Fabrello M, Artibani W. Prevalence, incidence and obstetric factors’ impact on female urinary incontinence in Europe: A systematic review. Urologia Internationalis. 2013;90: 1-9. https://doi. org/10.1159/000339929 google scholar
- 19. Biswas B, Bhattacharyya A, Dasgupta A, Karmakar A, Mallick N, Sembiah S. Urinary incontinence, its risk factors, and quality of life: A study among women aged 50 years and above in a rural health facility of West Bengal. J Mid-life Health. 2017;8:130-6. doi: 10.4103/jmh.JMH_62_17. google scholar
- 20. Aniuliene R, Aniulis P, Steibliene V. Risk factors and types of urinary incontinence among middle-aged and older male and female primary care patients in kaunas region of Lithuania: Cross sectional study. Miscellaneous. 2015;13(1): 2552-61. google scholar
- 21. R0rtveit G, Hannestad YS. Association between mode of delivery and pelvic floor dysfunction. Tidsskr Nor Legeforen. 2014;19(134): 1848 - 52. google scholar
- 22. Royal College of Obstetricians and Gynaecologists. The Management of third- and fourth-degree perineal tears green-top guideline [homepage on the Internet]. 2015. Available from https://www.rcog.org.uk/globalassets/documents/guidelines/ gtg-29.pdf. google scholar
- 23. Kılıç M. Incidence and risk factors of urinary incontinence in women visiting Family Health Centers. Springer Plus. 2016;5:1331. google scholar
- 24. Ural Büyükbesnili Z. Enuresis. J Pediatr Surg. 2016;30(6): 575-82. google scholar
- 25. Slieker-ten Hove MC, Pool-Goudzwaard AL, Eijkemans MJ, Steegers-Theunissen RP, Burger CW, Vierhout ME. The prevalence of pelvic organ prolapse symptoms and signs and their relation with bladder and bowel disorders in a general female population. International Urogynecology Journal and Pelvic Floor Dysfunction. 2009;20:1037-45. doi: 10.1007/ s00192-009-0902-1. google scholar
- 26. Yıldız Ç, Akkar ÖB, Karakuş S, Korğalı E. Sexual life after pelvic surgery in women. Andrology Bulletin. 2016;17(60): 56-9. google scholar
- 27. Jennifer MW, Hundley AF, Fulton RG, Myers ER. Forecasting the prevalence of pelvic floor disorders in U.S. women. Obstetrics & Gynecology. 2009;114(6): 1278-83. google scholar
- 28. Vergeldt TFM, Weemhoff M, IntHout J, Kluivers KB. Risk factors for pelvic organ prolapse and its recurrence: a systematic review. Int Urogynecol J. 2015;26:1559-73. doi: 10.1007/s00192-015-2695-8 google scholar
- 29. Masenga GG, Shayo BC, Rasch V. Prevalence and risk factors for pelvic organ prolapse in Kilimanjaro, Tanzania: A population-based study in Tanzanian rural community. Plos One. 2018;13(4): 1-13. doi: 10.1371/journal.pone.0195910 google scholar
- 30. Elbiss HM, Osman N, Hammad FT. Prevalence, risk factors and severity of symptoms of pelvic organ prolapse among Emirati women. BMC Urology. 2015;15:66. google scholar
- 31. Kömürcü Ö, Uğur GM. Pelvic floor changes due to birth. Bulletin of Continence and Neurourology. 2017;4: 25-34. google scholar
- 32. Bilgiç D, Kızılkaya Beji N, Yalçın Ö. Evaluation of sexual function in patients with urogynecology. Journal of Turkish Society of Obstetrics and Gynecology. 2012;9(3): 142-52. google scholar
- 33. Yount SM. The Impact of pelvic floor disorders and pelvic surgery on women’s sexual satisfaction and function. Journal of Midwifery &Women’s Health. 2013;538-45. google scholar
- 34. Yıldız E, Dinçgez Çakmak B, Ketenci Gencer F, Aydın Boyama B. Frequency, severity and risk factors of pelvic organ prolapse in perimenopausal women. Okmeydanı Medical Journal. 2018;34(2):148-53. google scholar
- 35. Li-Yun-Fong RJ, Larouche M, Hyakutake M, et al. Is pelvic floor dysfunction an independent threat to sexual function? A cross-sectional study in women with pelvic floor dysfunction. J Sex Med. 2017;14:226-37. doi: 10.1016/j.jsxm.2016.11.323. google scholar
- 36. Novi JM, Jeronis S, Morgan MA, Arya LA. Sexual function in women with pelvic organ prolapse compared to women without pelvic organ prolapse. Journal of Urology. 2005;173: 1669-72. doi: 10.1007/s001920170012. google scholar
- 37. Çayan S, Yaman Ö, Orhan İ, et al. Prevalence of sexual dysfunction and urinary incontinence and associated risk factors in Turkish women. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2016;203: 303-8. doi: 10.1016/j. ejogrb.2016.06.030. google scholar
- 38. Turhan A, Akhan SE, Bastu E, Güngör Uğurlucan F, Yasa C, Oskay Ü, Yalçın Ö. The effect of urinary incontinence on sexual functioning in Turkish women of reproductive and menopausal ages. International Journal of Sexual Health. 2015;27(4):396-405. google scholar
Year 2024,
Issue: 4, 17 - 25, 29.02.2024
Merve Tuncer
,
Ümran Oskay
,
Özlem Öner
References
- 1. Farrell E. Genitourinary syndrome of menopause. RCOG. 2017;46(7):481-4. google scholar
- 2. Mitchell CM, Reed SD, Diem S, et al. Efficacy of vaginal estradiol or vaginal moisturizer vs placebo for treating postmenopausal vulvovaginal symptoms: A randomized clinical trial. JAMA Internal Medicine. 2018;178(5): 681-90. doi: 10.1001/ jamainternmed.2018.0116. google scholar
- 3. Jennifer MW, Hundley AF, Fulton RG, et al. Forecasting the prevalence of pelvic floor disorders in U.S. women. Obstet Gynecol. 2009;114(6): 1278-83. doi: 10.1097/ AOG.0b013e3181c2ce96. google scholar
- 4. Dellü MC, Schmitt ACB, Cardoso MRA, et al. Prevalence and factors associated with urinary incontinence in climacteric. Rev Assoc Med Bras. 2016;62(5):441-6. doi: 10.4103/ijcm. IJCM_29_19 google scholar
- 5. Topuz Ş. Urinary incontinence and sexuality. Balıkesir J Health Sci. 2015;4(1): 60-4. google scholar
- 6. Gupta N, Aggarwal M, Sinha R, et al. Study on prevalence and severity of urogenital complaints in postmenopausal women at a tertiary care hospital. J Mid Health. 2018;9:130-4. doi: 10.4103/jmh.JMH_91_17 google scholar
- 7. Yeşiltepe Oskay U, Kızılkaya Beji N, Yalçın O. A study on urogenital complaints of postmenopausal women aged 50 and over. Acta Obstet Gynecol Scand. 2005;84: 72-8. google scholar
- 8. Grzybowska MR, Wydra DG. Coital incontinence: a factor for deteriorated health-related quality of life and sexual function in women with urodynamic stress urinary incontinence. Int Urogynecol J. 2017;28: 697-704. doi: 10.1007/s00192-016-3185-3. google scholar
- 9. Santoro N, Epperson N, Mathews SB. Menopausal symptoms and their management. Endocrinology and Metabolism Clinics of North America. 2015;44(3): 497-515. doi: 10.1016/j. ecl.2015.05.001 google scholar
- 10. Kılıç M, Ejder Apay S, Kızılkaya Beji N. Sexual function disorders and nursing approach due to pelvic organ prolapse. I.U.F.N. Journal of Nursing.2011;19(3): 194-202. google scholar
- 11. Cam Ç, Sancak P, Karahan N, et al. Validation of the short form of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) in a Turkish population. European J Obstet Gynecology and Reproductive Bio. 2009;146: 104-7. doi: 10.1016/j.ejogrb.2009.05.016. google scholar
- 12. Hoga LAK, Rodolpho JRC, Gonçalves BG, Quirino B. Women’s experiences of menopause: A systematic review protocol of qualitative evidence. JBI Database System Rev Implement Rep. 2014;12(7): 72 - 81. doi: 10.11124/jbisrir-2015-1948. google scholar
- 13. Sis Çelik A, Pasinlioğlu T. The symptoms of climacteric period and the role of the nurse. Erciyes University Faculty of Health Scien J. 2013;1(1): 48-56. google scholar
- 14. Jha S, Gopinath D. Prolapse or incontinence: what affects sexual function the most? Int Urogynecol J. 2016;27: 607-611. doi: 10.1007/s00192-015-2887 google scholar
- 15. Güdücü N, Özcan Keser N. Evaluation of sexual functions of women with urinary incontinence. J Academic Res in Nursing. 2016;2(1):16-23. google scholar
- 16. Şentürk S, Kara M. Risk factors and prevalence of urinary incontinence in postmenopausal women living in Turkey. Clinical and Experimental Obstetrics & Gynecology 2011;69-71. google scholar
- 17. Şensoy N, Doğan N, Özek B, Karaaslan L. Urinary incontinence in women: prevalence rates, risk factors and impact on quality of life. Pakistan Journal of Medical Sciences. 2013;29(3): 818-22. google scholar
- 18. Cerruto MA, D’Elia C, Aloisi A, Fabrello M, Artibani W. Prevalence, incidence and obstetric factors’ impact on female urinary incontinence in Europe: A systematic review. Urologia Internationalis. 2013;90: 1-9. https://doi. org/10.1159/000339929 google scholar
- 19. Biswas B, Bhattacharyya A, Dasgupta A, Karmakar A, Mallick N, Sembiah S. Urinary incontinence, its risk factors, and quality of life: A study among women aged 50 years and above in a rural health facility of West Bengal. J Mid-life Health. 2017;8:130-6. doi: 10.4103/jmh.JMH_62_17. google scholar
- 20. Aniuliene R, Aniulis P, Steibliene V. Risk factors and types of urinary incontinence among middle-aged and older male and female primary care patients in kaunas region of Lithuania: Cross sectional study. Miscellaneous. 2015;13(1): 2552-61. google scholar
- 21. R0rtveit G, Hannestad YS. Association between mode of delivery and pelvic floor dysfunction. Tidsskr Nor Legeforen. 2014;19(134): 1848 - 52. google scholar
- 22. Royal College of Obstetricians and Gynaecologists. The Management of third- and fourth-degree perineal tears green-top guideline [homepage on the Internet]. 2015. Available from https://www.rcog.org.uk/globalassets/documents/guidelines/ gtg-29.pdf. google scholar
- 23. Kılıç M. Incidence and risk factors of urinary incontinence in women visiting Family Health Centers. Springer Plus. 2016;5:1331. google scholar
- 24. Ural Büyükbesnili Z. Enuresis. J Pediatr Surg. 2016;30(6): 575-82. google scholar
- 25. Slieker-ten Hove MC, Pool-Goudzwaard AL, Eijkemans MJ, Steegers-Theunissen RP, Burger CW, Vierhout ME. The prevalence of pelvic organ prolapse symptoms and signs and their relation with bladder and bowel disorders in a general female population. International Urogynecology Journal and Pelvic Floor Dysfunction. 2009;20:1037-45. doi: 10.1007/ s00192-009-0902-1. google scholar
- 26. Yıldız Ç, Akkar ÖB, Karakuş S, Korğalı E. Sexual life after pelvic surgery in women. Andrology Bulletin. 2016;17(60): 56-9. google scholar
- 27. Jennifer MW, Hundley AF, Fulton RG, Myers ER. Forecasting the prevalence of pelvic floor disorders in U.S. women. Obstetrics & Gynecology. 2009;114(6): 1278-83. google scholar
- 28. Vergeldt TFM, Weemhoff M, IntHout J, Kluivers KB. Risk factors for pelvic organ prolapse and its recurrence: a systematic review. Int Urogynecol J. 2015;26:1559-73. doi: 10.1007/s00192-015-2695-8 google scholar
- 29. Masenga GG, Shayo BC, Rasch V. Prevalence and risk factors for pelvic organ prolapse in Kilimanjaro, Tanzania: A population-based study in Tanzanian rural community. Plos One. 2018;13(4): 1-13. doi: 10.1371/journal.pone.0195910 google scholar
- 30. Elbiss HM, Osman N, Hammad FT. Prevalence, risk factors and severity of symptoms of pelvic organ prolapse among Emirati women. BMC Urology. 2015;15:66. google scholar
- 31. Kömürcü Ö, Uğur GM. Pelvic floor changes due to birth. Bulletin of Continence and Neurourology. 2017;4: 25-34. google scholar
- 32. Bilgiç D, Kızılkaya Beji N, Yalçın Ö. Evaluation of sexual function in patients with urogynecology. Journal of Turkish Society of Obstetrics and Gynecology. 2012;9(3): 142-52. google scholar
- 33. Yount SM. The Impact of pelvic floor disorders and pelvic surgery on women’s sexual satisfaction and function. Journal of Midwifery &Women’s Health. 2013;538-45. google scholar
- 34. Yıldız E, Dinçgez Çakmak B, Ketenci Gencer F, Aydın Boyama B. Frequency, severity and risk factors of pelvic organ prolapse in perimenopausal women. Okmeydanı Medical Journal. 2018;34(2):148-53. google scholar
- 35. Li-Yun-Fong RJ, Larouche M, Hyakutake M, et al. Is pelvic floor dysfunction an independent threat to sexual function? A cross-sectional study in women with pelvic floor dysfunction. J Sex Med. 2017;14:226-37. doi: 10.1016/j.jsxm.2016.11.323. google scholar
- 36. Novi JM, Jeronis S, Morgan MA, Arya LA. Sexual function in women with pelvic organ prolapse compared to women without pelvic organ prolapse. Journal of Urology. 2005;173: 1669-72. doi: 10.1007/s001920170012. google scholar
- 37. Çayan S, Yaman Ö, Orhan İ, et al. Prevalence of sexual dysfunction and urinary incontinence and associated risk factors in Turkish women. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2016;203: 303-8. doi: 10.1016/j. ejogrb.2016.06.030. google scholar
- 38. Turhan A, Akhan SE, Bastu E, Güngör Uğurlucan F, Yasa C, Oskay Ü, Yalçın Ö. The effect of urinary incontinence on sexual functioning in Turkish women of reproductive and menopausal ages. International Journal of Sexual Health. 2015;27(4):396-405. google scholar