Lower urinary tract symptoms' impact on women's sexual health significant

Orlando, FL–Lower urinary tract symptoms can put a damper on women's sexual enjoyment and activity for many. Urologists and their clinical staffs can help these women.

Open the conversation with your pa–tients, urged Karin Coyne, PhD, senior research leader at United BioSource Corp., Bethesda, MD, which conducted a large epidemiologic study known as EpiLUTS, sponsored by Pfizer.

Overall, the Internet-based survey included 20,000 people in the United States, 7,500 in the United Kingdom, and 2,500 in Sweden. At the AUA annual meeting, Dr. Coyne presented results of the sexual health portion of the survey for 8,013 U.S. and 3,135 UK women. The respondents' mean age was 55 years in the United States and 57 in the United Kingdom. Most-64.6% in the United States and 67.9% in the United Kingdom-were married or living with a partner.

The most prevalent incontinence problems in these women were stress incontinence (in 32.3% of U.S. women and 21.3% of UK women) and urge incontinence (in 24.9% of the U.S. women and 22.9% of the UK women). Interestingly, 7% of the U.S. women and 8% of the UK women reported bladder pain.

A little more than half of the women said they were currently sexually active (58.3% of U.S. and 52.9% of UK women). The most common reason for not being sexually active was no partner (48.1% and 45.1%, respectively), followed by lack of desire (22.9% and 25.6%, respectively).

Among all the women reporting LUTS, 4.4% in the United States and 2.8% in the United Kingdom reported having bladder pain with intercourse.

Effect of LUTS on sex

The presence of LUTS decreased enjoyment of sex "somewhat" or "a great deal" for 14% of U.S. women and 13% of UK women. LUTS also caused 11% of the U.S. women and 11% of the UK women to decrease their sexual activity or stop having sex altogether.

The most prominent LUTS that decreased enjoyment were urinary incontinence during intercourse, bladder pain during intercourse, postvoid urinary incontinence, and symptoms of dysuria, frequency, urgency, incomplete emptying, and weak stream.

"Sexual health should be assessed in women presenting with LUTS, and vice versa: Women with sexual health problems should be assessed for LUTS," said Dr. Coyne, who urged urologists to "raise the issue with women."

But how to raise the issue provoked lively discussion among audience members. One male urologist said that his female patients tell him, no, they don't have those problems, but once he leaves the room, they will tell the female nurse practitioner that they do. Because of gender issues, urologists may be wise to enlist the help of a clinical staffer who is the same gender as the patient to bring these problems to the fore and address them.