Presented by: Ben Sionov MD
Urologic Surgery, Wolfson medical centre, Holon, Israel

Introduction

Urinary incontinence is a bothersome condition and has a detrimental effect on quality of life. The literature on the matter is unfortunately limited, few women actively initiate the discussion about this issue. 

In this study we aimed to report the incidence, diagnosis and management results of urinary incontinence during intercourse. 

Materials

Retrospective analysis of patients with stress urinary incontinence (SUI) who underwent surgery for this problem between 2019 and 2022 was performed. Inclusion criteria were age under 60 years old (in this age range women are mostly sexually active), surgery for stress incontinence and follow up for at least three months. Clinical data including information on urinary incontinence during intercourse, diagnosis, management and treatment results were collected and analyzed. 

Results

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Of 103 women, 59 were included- of them, 27 patients (46%) with average age of 49.2 (range 40-59) suffered from urinary incontinence during sexual intercourse prior to treatment. None of the patients complained until deliberately asked. Only one woman had urinary incontinence during orgasm, the other experienced incontinence during all stages of intercourse. 

The patients were ulteriorly divided based on the severity of the incontinence according to pads used daily; 5 pads or more 11 (40.7%) of the patients, 3-4 pads 12 (44%), 1-2 pads 3 women and one patient didn’t use pads.

 All the patients underwent mid urethral sling surgery. In addition, pelvic organ prolapse repair was performed in two patients. In 23 patients (85.2%) urinary incontinence resolved following surgery including incontinence during intercourse. In the remaining 4 women the surgery was not successful both for stress and during intercourse. 

Conclusion

Urinary incontinence during sexual intercourse is very frequent. Direct questioning is critical to diagnose and discover this condition. 

This subgroup of patients should be considered as a severe form of urinary incontinence.

Funding

none

Lead Authors

Masha Ben Zvi, MD
Obstetrics and Gynaecology, Wolfson medical centre, Holon, Israel

Alexander Tsivian, MD
Urologic Surgery, Wolfson medical centre, Holon, Israel