Comparison of Quality of Life and Sexual Functions of Obese and Non-Obese Women with Urinary Incontinence

Öz

Aim: Sexual function is important for quality of life and sexual dysfunction is more common in women with urinary incontinence than asymptomatic women. We evaluated the effect of obesity on quality of life and sexual functions of women with urinary incontinence. Material and Methods: A prospective case control study was conducted between January and April 2020 at Zonguldak Bulent Ecevit University, School of Medicine, Obstetrics and Gynecology Department. Women who agreed to answer the questionnaires, older than 18 years of age and sexually active were included to our study. Women who had psychiatric or neurological disease, had pelvic organ prolapsus greater than stage 2 and not completed the the questionnaires were excluded. A total of thirthy seven patients were categorized as obese group and thirthy one patients were categorized as non-obese group due to their body mass index. Incontinence Impact Questionnaire (IIQ-7), Urogenital Distress Inventory (UDI-6), Overactive Bladder Questionnaire (OAB-V8), Pelvic Organ Prolapse/ Urinary Incontinence Sexual Questionnaire (PISQ-12) were used to evaluate quality of life and sexual functions. Results: Mixed incontinence was the most common type of urinary incontinence in both groups (54.1% vs 38.7%). UDI-6 total scores were higher in obese patients than non-obese patients (58.30 vs 29.16 p=0.001). Also OAB-V8 total scores were higher in obese patients than non-obese patients (21.00 vs 12.00 p=0.002). IIQ-7 total scores were similar in both groups (p=0.795). On the other hand PISQ12 total scores that positively correlated to better sexual functions, were higher in non-obese patients than obese patients (28.00 vs 27.00 p=0.026). A weak but significant negative correlation between body mass index (BMI) and PISQ-12 scores (r= -0.296, p=0.027), and moderate positive correlation between BMI and UDI-6 scores (r=0.431, p<0.001), and OAB-V8 scores (r=0.490, p<0.001) were obtained. Conclusion: Sexual dysfunction were more common in obese women with urinary incontinence than non-obese women with urinary incontinence. More comprehensive assesment that focusing more to sexual functions would be more suitable to increase the quality of life of patients with urinary incontinence.

Anahtar Kelimeler

• Urinary incontinence,
• Sexual dysfunction
• Obesity
• Quality of life

Üriner İnkontinans Bulunan Obez ve Obez Olmayan Kadınların Hayat Kalitelerinin ve Seksüel Fonksiyonlarının Karşılaştırılması

Öz

Amaç: Seksüel fonksiyonlar genel hayat kalitesini etkileyen önemli faktörlerdendir. Özellikle de üriner inkontinanslı hastalarda seksüel fonksiyon bozuklukları asemptomatik kadınlara göre daha sık olarak görülmektedir. Bu çalışmada obezitenin, üriner inkontinans bulunan kadınların hayat kalitelerine ve seksüel fonksiyonlarına etkisi araştırılmıştır. Gereç ve Yöntemler: Ocak 2020- Nisan 2020 tarihleri arasında, Zonguldak Bülent Ecevit Üniversitesi Sağlık Uygulama ve Araştırma Merkezi Kadın Hastalıkları ve Doğum Ana Bilim Dalı, Kadın Hastalıkları Polikliniği’ne idrar kaçırma şikayeti ile başvuran kadınlar değerlendirilmiştir. Sorgu formlarını cevaplamayı kabul eden, 18 yaş ve üzerinde, seksüel olarak aktif olan hastalar çalışmaya dahil edilirken, sorgu formlarını eksik cevaplayan, nörolojik ve psikiyatrik hastalığı bulunan, evre 2 ve üzeri pelvik organ prolapsusu bulunan hastalar dışlanmıştır. 67 hastanın, vücut kütle indeksi (VKİ) ≥30 olan 37’si obez grup, VKİ<30 olan 31’i ise obez olmayan grup olarak ayrılmıştır. Çalışmada hayat kalitesi ve seksüel fonksiyonları değerlendirmek için İnkontinans Etki Anketi (‘Incontinence Impact Questionnaire, IIQ-7), Ürogenital Distres Envanteri (‘Ürogenital Distress Inventory’, UDI-6), Aşırı Aktif Mesane Anketi (Overactive Bladder Questionnaire, OAB-V8) ve Pelvik Organ Prolapsusu / Üriner İnkontinans Cinsel Anketi (Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire, PISQ-12) sorgu formları kullanılmıştır. Bulgular: Obez ve obez olmayan grupta en sık görülen üriner inkontinans tipi mikst inkontinans (sırasıyla %54,1 ve %38,7) olarak belirlenmiştir. Obez hastalarda, obez olmayan hastalara göre daha yüksek UDI-6 total skoru (sırasıyla 58,30 ve 29,16 p=0,001) ve daha yüksek OAB-V8 total skoru (sırasıyla 21,00 ve 12,00 p=0,002) saptanmıştır. IIQ-7 total skorları açısından gruplar arasında fark gözlenmemiştir (p=0,795). Öte yandan yüksek skorların seksüel fonksiyonlarındaki iyilik ile ilişkili olduğu PISQ-12 skorları ise obez olmayan grupta obez gruba göre anlamlı olarak daha yüksek saptanmıştır (sırasıyla 28,00 ve 27,00 p=0,026). VKİ ile PISQ-12 skorları arasında zayıf negatif korelasyon (r= -0,296, p=0,027), UDI-6 skorları ile orta derece pozitif korelasyon (r=0,431, p<0,001) ve OAB-V8 skorları ile orta derece pozitif korelasyon (r=0,490, p<0,001) olduğu ortaya çıkmıştır. Sonuç: Seksüel disfonksiyon, üriner inkontinansı bulunan obez hastalarda obez olmayan hastalardan daha yüksek oranda saptanmıştır. Bu grup hastalarda seksüel disfonksiyon varlığının araştırılması, sorunların öngörülebilmesine olanak sağlayarak hastaların hayat kalitelerinin artırılmasına olanak sağlayacaktır.

Anahtar Kelimeler

• Üriner inkontinans
• Seksüel disfonksiyon
• Obezite
• Hayat kalitesi

Kaynakça

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