Urinary incontinence linked to worse sexual function in patients with LUTS

Worse urinary incontinence appears to be associated with worse sexual function in patients presenting with lower urinary tract symptoms (LUTS), according to a study presented at the 2021 American Urological Association Annual Meeting.¹

Giuseppe Fallara, MD

“Patients with low urinary tract symptoms (LUTS) frequently complain [of] sexual dysfunction and sometimes even urinary incontinence (UI),” the authors wrote in their abstract.

For the cross-sectional study, the investigators retrospectively retrieved data from 938 patients older than 18 years of age seeking treatment for self-reported LUTS. Patients had to have a minimum International Prostate Symptom Score (IPSS) of at least 1 to be included. The cohort was stratified into categories as follows: no urinary incontinence (UI): International Consultation on Incontinence Questionnaire-Urinary Incontinence-Short Form (ICIQ-UI-SF) = 0; mild UI: ICIQ-UI-SF = 1-7; moderate UI: ICIQ-UI-SF = 8-13; and severe UI: ICIQ-UI-SF = 14-21. The Spearman correlation test was used to evaluate correlation between ICIQ-UI-SF and International Index of Erectile Function (IIEF) domain scores. Linear regression analysis tested putative risk factors associated with increased ICIQ-UI-SF scores.

Of the 938 patients studied, 589 (63%) had no UI, 247 (25%) had mild UI, 76 (8%) had moderate UI, and 36 (4%) had severe UI.

Although no substantial differences were found in total prostate-specific antigen levels and uroflowmetry levels among the groups, prostate volume, IPSS, and overactive bladder-questionnaire score were all higher as UI increased (P ≤ .03 for all).

The investigators also found a negative correlation between IIEF-Total (rho = –0.12; P < .001), IIEF-Erectile Function (rho = –0.15; P < .001), IIEF-Intercourse Satisfaction (rho = –0.1; P = .004), and IIEF-Overall Satisfaction scores (rho = –0.12; P < .001) and ICIQ-UI-SF scores. In addition, they reported that higher body mass index (Coeff 0.12; 95% CCI: .03-0.32, P = .011), diabetes (Coeff 1.76; 95% CI: .035-3.18, P = .015), and presence of comorbidities (Coeff 0.9; 95% CI: 0.06-0.174; P = .035) were all associated with higher ICIQ-UI-SF scores.

“In conclusion, we found that in patients presenting with LUTS, there is an association between urinary incontinence and [worse] sexual function,” said study author Giuseppe Fallara, MD, urology resident at San Raffaele Scientific Institute, Milan Italy, who worked on the study with Andrea Salonia, MD, and colleagues.

Reference

1. Fallara G, Boeri L, Candela L, et al. Impact of urinary incontinence on sexual function in patients presenting for lower urinary tract symptoms. Paper presented at 2021 American Urological Association Annual Meeting; September 10-13; virtual. Abstract PD04-07.