A Barrier to Sexual Function: Coital Urinary Incontinence

Öz

Coital urinary incontinence is defined as the leakage of urine during sexual intercourse. Coital urinary incontinence is generally associated with stress urinary incontinence and detrusor overactivity. Factors such as vaginal delivery, smoking, and pelvic organ prolapse are among the risk factors for coital urinary incontinence. Factors such as vaginal delivery, smoking, and pelvic organ prolapse are among the risk factors for coital urinary incontinence. It can be treated with conservative, pharmacological, and surgical interventions. A review of the literature shows that studies have demonstrated that coital urinary incontinence has a negative impact on sexual function and quality of life. Professional support is important to reduce these negative effects and improve women's quality of life. Women's health nurses should provide education to increase women's awareness and knowledge about coital urinary incontinence. Informative webinars on the subject should be organised in collaboration with the media. Nurses should provide information about treatment options and offer care recommendations to women undergoing treatment. Furthermore, they should make recommendations to the Ministry of Health to increase the number of urogynaecological outpatient clinics. In this way, nurses can play an active role in the treatment of coital urinary incontinence and improve women's quality of life.

Anahtar Kelimeler

• sexual intercourse
• urinary incontinence
• women

Cinsel Fonksiyonlara Engel: Koital Üriner İnkontinans

Öz

Koital üriner inkontinans, cinsel ilişki sırasında idrar kaçırma olarak tanımlanır. Koital üriner inkontinans genellikle stres idrar kaçırma ve detrusor aşırı aktivitesi ile ilişkilidir. Vajinal doğum, sigara kullanımı ve pelvik organ prolapsusu gibi faktörler koital üriner inkontinans için risk faktörleri arasındadır. Konservatif, farmakolojik ve cerrahi müdahalelerle tedavi edilebilir. Literatür taraması, koital üriner inkontinansın cinsel işlev ve yaşam kalitesi üzerinde olumsuz bir etkisi olduğunu gösteren çalışmalar göstermektedir. Bu olumsuz etkileri azaltmak ve kadınların yaşam kalitesini iyileştirmek için profesyonel destek önemlidir. Kadın sağlığı hemşireleri kadınların koital üriner inkontinans konusunda farkındalıklarını ve bilgilerini artırmak için eğitim sağlamalıdır. Konuyla ilgili bilgilendirici web seminerleri medya ile iş birliği içinde düzenlenmelidir. Hemşireler, tedavi gören kadınlara tedavi seçenekleri hakkında bilgi vermeli ve bakım önerileri sunmalıdır. Ayrıca, ürojinekoloji polikliniklerinin sayısının artırılması konusunda Sağlık Bakanlığı'na önerilerde bulunulmalıdır. Bu sayede hemşireler, koital üriner inkontinans tedavisinde aktif rol alabilir ve kadınların yaşam kalitesini artırabilir.

Anahtar Kelimeler

• cinsel ilişki
• üriner inkontinans
• kadın sağlığı hemşireliği

Kaynakça

1. Haylen BT, de Ridder D, Freeman RM, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) Joint Report on the terminology for female pelvic floor dysfunction. Int Urogynecol J 2010;21(1):5-26. doi:10.1007/s00192-009-0976-9
2. Rogers RG, Pauls RN, Thakar R, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) Joint Report on the terminology for the assessment of sexual health of women with pelvic floor dysfunction. Neurourol Urodyn 2018;37(4):1220-40. doi:10.1002/nau.23508.
3. Lau HH, Huang WC, Su TH. Urinary leakage during sexual intercourse among women with incontinence: Incidence and risk factors. PLoS One 2017;12:0177075.
4. Athey R, Gray T, Kershaw V, et al. Coital ıncontinence: A multicentre study evaluating prevalence and associations. Int Urogynecol J 2024;35(10):1969-75. doi:10.1007/s00192-024-05902-4.
5. Campbell M, Rattray C, Stewart P, et al. Profile of women with pelvic organ prolapse at the University Hospital of the West Indies risk factors and presentation. J Obstet Gynaecol 2022;42(6):2220-4. doi:10.1080/01443615.2022.2036963
6. Demir O, Comba C. Investigation of the incidence of coital incontinence in incontinent women. Gynecol Obstet Reprod Med.2020;26(2):130-3.
7. El-Azab AS, Yousef HA, Seifeldein GS. Coital incontinence: Relation to detrusor overactivity and stress incontinence. Neurourol Urodyn 2011;30(4):520-4. doi:10.1002/nau.21041
8. Jha S, Strelley K, Radley S. Incontinence during intercourse: Myths unravelled. Int Urogynecol J 2012;23(5):633-7. doi:10.1007/s00192-011-1583-0

9. Ratner ES, Erekson EA, Minkin MJ, et al. Sexual satisfaction in the elderly female population: A special focus on women with gynecologic pathology. Maturitas 2011;70(3):210-15. doi:10.1016/j.maturitas.2011.07.015
10. Madhu C, Hashim H, Enki D, et al. Coital incontinence: What can we learn from urodynamic assessment? Urology 2015;85:1034–8. doi: 10.1016/j.urology.2015.02.007
11. Moran PA, Dwyer PL, Ziccone SP. Urinary leakage during coitus in women. J Obstet Gynaecol 1999;19:286–8. doi: 10.1080/01443619965084
12. Pastor Z. Female ejaculation orgasm vs. coital incontinence: A systematic review. J Sex Med 2013;10(7):1682-91. doi:10.1111/jsm.12166
13. Barber MD, Dowsett SA, Mullen KJ, et al. The impact of stress urinary incontinence on sexual activity in women. Cleve Clin J Med 2005;72(3):225-32. doi:10.3949/ccjm.72.3.225
14. Cartwright R, Elvy S, Cardozo L. Do women with female ejaculation have detrusor overactivity? J Sex Med 2007;4:1655–8.
15. Dietz HP, Subramaniam N. Is coital incontinence a manifestation of urodynamic stress incontinence or detrusor overactivity? Int Urogynecol J 2022;33(5):1175-8. doi:10.1007/s00192-021-04809-8
16. Çetinkaya ŞE, Seval MM, Varlı B, et al. The association of coital incontinence with clinical factors and single voiding cycle ambulatory urodynamic monitoring findings in women. Front Med (Lausanne) 2023;10:1160637. Published 2023 Mar 28. doi:10.3389/fmed.2023.1160637
17. Duralde ER, Rowen TS. Urinary incontinence and associated female sexual dysfunction. Sex Med Rev 2017;5(4):470-85. doi:10.1016/j.sxmr.2017.07.001
18. Illiano E, Mahfouz W, Giannitsas K, et al. Coital incontinence in women with urinary incontinence: An international study. J Sex Med 2018;15(10):1456-62. doi:10.1016/j.jsxm.2018.08.009
19. Erol B, Ateş Kadıoğlu A. İnkontinans ve cinsel yaşam. Onur R, Bayrak Ö, editörler. Üriner inkontinans tanı ve tedavi. Tüd/Türk Üroloji Akademisi Yayını No:2; 2015. p. 19-124.
20. Maslow AH. A theory of human motivation. Psychological Review 1943;50(4):370–96. doi:10.1037/h0054346. hdl:10983/23610
21. van Rensburg K. Sexual function in women with urinary incontinence. Stephen Jeffery and Peter de Jong, eds. Textbook of Urogynaecology, Creative Commons Attributive Licence; 2010. p.1-220.
22. National Collaborating Centre for Women’s and Children’s Health (UK). Urinary incontinence in women: The management of urinary ıncontinence in women. London: Royal College of Obstetricians and Gynaecologists (UK); 2013.
23. McClurg D, Pollock A, Campbell P, et al. Conservative interventions for urinary incontinence in women: An overview of Cochrane systematic reviews. Cochrane Database Syst Rev 2016 Sep 1;2016(9):CD012337. doi: 10.1002/14651858.CD012337
24. Hay-Smith EJ, Herderschee R, Dumoulin C, et al. Comparisons of approaches to pelvic floor muscle training for urinary incontinence in women. Cochrane Database Syst Rev 2011;(12):CD009508. Published 2011 Dec 7. doi:10.1002/14651858.CD009508
25. Todhunter-Brown A, Hazelton C, Campbell P, et al. Conservative interventions for treating urinary incontinence in women: An overview of Cochrane systematic reviews. Cochrane Database Syst Rev 2022;9(9):CD012337. Published 2022 Sep 2. doi:10.1002/14651858.CD012337.pub2
26. Gormley EA, Lightner DJ, Faraday M et al. Diagnosis and treatment of overactive bladder (non-neurogenic) in adults: AUA/SUFU guideline amendment. J Urol 2015;193(5):1572-80. doi:10.1016/j.juro.2015.01.087
27. Hwang J-C, Sun F-J, Su T-H, et al. Efficacy of biofeedback and electrostimulation-assisted pelvic floor muscle training between women with mild and moderate to severe stress urinary incontinence. Journal of Clinical Medicine 2022;11(21):6424. https://doi.org/10.3390/jcm11216424
28. Siff LN, Hill AJ, Walters SJ, et al. The effect of commonly performed exercises on the levator hiatus area and the length and strength of pelvic floor muscles in postpartum women. Female Pelvic Med Reconstr Surg 2020;26(1):61–6. doi: 10.1097/SPV.0000000000000590
29. Briskin RS, Luck AM. Effects of pure barre exercise on urinary incontinence symptoms: A prospective observational cross-sectional study. Urogynecology (Phila) 2023;29(12):938-45. doi:10.1097/SPV.0000000000001363
30. Hayes SC, Hofmann, SG. The third wave of cognitive behavioral therapy and the rise of process-based care. World Psychiatry 2017;16:245–6.
31. Moradinasab S, Iravani M, Mousavi P, et al. Effect of cognitive-behavioral therapy on sexual self-esteem and sexual function of reproductive-aged women suffering from urinary incontinence. Int Urogynecol J 2023;30:1–11. doi: 10.1007/s00192-023-05460-1. 
32. Arroyo C. Fractional CO2 laser treatment for vulvovaginal atrophy symptoms and vaginal rejuvenation in perimenopausal women. Int J Womens Health 2017;9:591-5. doi:10.2147/IJWH.S136857
33. Mezzana, P. Two wavelengths endovaginal laser system: Clinical evaluation of a new device for mild SUI and vaginal atrophy treatment. Dermatologic Therapy 2020; 33:e14445. https://doi.org/10.1111/dth.14445
34. Kansu Çelik H, Kısa Karakaya B, Aksakal OS, Evliyaoğlu Ö. Kadınlarda stres üriner inkontinansın farmakolojik tedavisi. JGON 2017;14(3):127-32.
35. Yıldız Ş, Turan Z. Nursing approaches for women with ürinary incontinence. SAUHSD 2021;4(3):155-66. doi: 10.54803/sauhsd.1017030
36. Trowbridge ER, Hoover EF. Evaluation and treatment of urinary ıncontinence in women. Gastroenterol Clin North Am 2022;51(1):157-75. doi:10.1016/j.gtc.2021.10.010
37. Carr R. Urinary Incontinence. In: South-Paul JE, Matheny SC, Lewis EL, editors. Current diagnosis & Treatment: Family Medicine, 5e. New York: McGraw-Hill; 2020.
38. American College of Obstetricians and Gynecologists. Urinary incontinence in women. Practice Bulletin No. 155. American College of Obstetricians and Gynecologists. Obstet Gynecol 2015;126:c66–81
39. Evrüke İM, Taş İS. The effect of solifenacin treatment for urge urinary incontinence on sexual function in premenopausal and postmenopausal women: A prospective observational study. Cukurova Medical Journal 2023;48(13):200-7. doi:10.17826/cumj.1227597
40. Shawer S, Khunda A, Waring GJ, et al. Impact of intravesical onabotulinumtoxin A (Botox) on sexual function in patients with overactive bladder syndrome: A systematic review and meta-analysis. Int Urogynecol J 2022;33(2):235-43. doi: 10.1007/s00192-021-05072-7
41. Serati M, Braga A, Scancarello C, et al. Does the Polydimethylsiloxane Urethral Injection (Macroplastique®) improve sexual function in women, in fertile age, affected by stress urinary ıncontinence? Medicina (Kaunas). 2023;59(3):580 doi:10.3390/medicina59030580
42. Hermieu JF. Suburethral bands in women urinary stress incontinence: A review of the various techniques. Ann Urol (Paris) 2005;39:124–36
43. Zalewski M, Kołodyńska G, Zalewska A, et al. Comparative assessment of female sexual function following transobturator midurethral sling for stress urinary incontinence. Int J Environ Res Public Health 2021;18(5):2286. doi:10.3390/ijerph18052286
44. Yüksel Özgör B, Özgör F, Yalçın Bahat P, et al. Killing two birds with one stone: Treatment of female urinary incontinence improves female and male sexual function. Haydarpasa Numune Med J 2022;62(1):8–12. doi: 10.14744/hnhj.2019.03780
45. Schiavi MC, Carletti V, Yacoub V, et al. Evaluation of the efficacy and safety of single incision sling vs TVT-O in obese patients with stress urinary incontinence: Quality of life and sexual function analysis. Taiwan J Obstet Gynecol 2023;62(1):89-93. doi: 10.1016/j.tjog.2022.07.011
46. Akhan SE. Pelvis Taban ve Cinsel Yaşam: Bölüm 51. Yalçın Ö, editör. Temel Ürojinekoloji. 1. Baskı. İstanbul, Nobel Tıp Kitabevleri Ltd. 2009. p.525- 41.
47. Karbage SA, Santos ZM, Frota MA, et. al. Quality of life of Brazilian women with urinary incontinence and the impact on their sexual function. Eur J Obstet Gynecol Reprod Biol 2016;201:56-60. doi:10.1016/j.ejogrb.2016.03.025
48. Nilsson M, Lalos O, Lindkvist H, Lalos A. Impact of female urinary incontinence and urgency on women’s and their partners’ sexual life. Neurourol Urodyn 2011;30(7):1276-80. doi:10.1002/nau.21039