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

Yıl 2020, , 84 - 89, 30.08.2020

Adile Yeşim Akdemir , Konul Navruzova Mustafa Çağatay Büyükuysal , Ülkü Özmen , Müge Harma , Mehmet Harma

https://doi.org/10.25048/tudod.713971

Cited By: 1

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

• 1) Dratva J, Go´mez Real F, Schindler C, et al. Is age at menopause increasing across Europe? Results on age at menopause and determinants from two population-based studies. Menopause 2009;16:385-394.
• 2) Tam, AA, and Cakir B. Approach of obesity ın primary health care. Ankara Medical 2012 Journal. 12(1):37-41.
• 3) Flegal KM, Graubard BI, Williamson DF, Gail MH. Cause-specific excess deaths associated with underweight, overweight, and obesity. JAMA 2007;298:2028-2037.
• 4) Andersen JT, Blaivas JG, Cardozo L, et al. ICS 7th report on the standardisation of terminology of lower urinary tract function-Lower urinary tract rehabilitation techniques. Neurourol Urodyn 1992; 11: 593–603.
• 5) Subak LL, Richter HE, Hunskaar S. Obesity and Urinary Incontinence: Epidemiology and Clinical Research Update. J. Urol. 2009;182:S2–S7.
• 6) Barber, MD. 2016. Pelvic organ prolapse. British Medical Journal, 354;3853:1-9
• 7) Monz B,Chartier-Kastler E, Hampel C, Samsioe G, Hunskaar S, Espuna-Pons M, Chinn C. Patient characteristics associated with quality of life in European women seeking treatment for urinary incontinence: results from PURE. Europen Urology. 2007 51(4): 1073–1081
• 8) Muennig P, Lubetkin E, Jia H, Franks P. Gender and the burden of disease attributable to obesity. 2006 American Journal of Public Health. 96(9):1662–1668.
• 9) Pomian, A., W. Lisik, M. Kosieradzki, and E. Barcz. 2016. Obesity and pelvic floor disorders: A review of the literature. Medical Science Monitor. 3(22):1880- 1886.
• 10) Shumaker, S.A., J.F. Wyman, J.S. Uebersax, D. McClish, and J.A. Fantl. Health- related QOL measures for women with urinary incontinence: The incontinence impact questionnaire and urogenital distress inventory. Quality of Life Research. 1994 3(5):291-306.
• 11) Uebersax, J.S., J.F. Wyman, S.A. Shumaker, D. McClish, and J.A. Fantl. Short forms to assess life quality and symptom distress for urinary incontinence in women: The incontinence impact questionnaire and urogenital distress inventory. Neurourology and Urodynamics. 1995 14(2):131-139.
• 12) Acquadro C, Kopp Z, Coyne KS, et al. Translating overactive bladder questionnaires in 14 languages. Urology. 2006; 67: 536– 540.
• 13) Rogers, R.G., K.W. Coates, D. Kammerer-Doak, S. Khalsa, and C. Qualls. A short form of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12). International Urogynecology Journal of Pelvic Floor Dysfunction. 2003 14(3):164-168.
• 14) Cam C, Sakalli M, Ay P, Cam M, Karateke A. Validation of the short forms of the incontinence impact questionnaire (IIQ-7) and the urogenital distress inventory (UDI-6) in a Turkish population. Neurourol Urodyn. 2007;26(1):129-33.
• 15) Cam C, Sancak P, Karahan N, Sancak A, Celik C, Karateke A. Validation of the short form of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) in a Turkish population. Eur J Obstet Gynecol Reprod Biol. 2009 Sep;146(1):104-7.
• 16) Moller LA, Lose G. Sexual activity and lower urinary tract symptoms. Int Urogynecol J Pelvic Floor Dysfunct. 2005;17:18–21.
• 17) Dalpiaz O, Kerschbaumer A, Mitterberger M, Pinggera GM, Colleselli D, Bartsch G, et al. Female sexual dysfunction: a new urogynecological research field. BJU Int. 2008;101:717–21
• 18) Esposito K, Giugliano F, Ciotola M, De Sio M, D’Armiento M, Giugliano D. Obesity and sexual dysfunction, male and female. Int J Impot Res 2008;20:358-365.
• 19) Ambler DR, Bieber EJ, Diamond MP. Sexual function in elderly women: a review of current literature. Rev Obstet Gynecol. 2012;5:16–27
• 20) Serati M, Salvatore S, Uccella S, Cromi A, Khullar V, Cardozo L, et al. Urinary incontinence at orgasm: relation to detrusor activity and treatment efficacy. Eur Urol. 2008;54:911–7.
• 21) Kinzl JF, Trefalt E, Fiala M, Hotter A, Biebl W, Aigner F. Partnership, sexuality, and sexual disorders in morbidly obese women: consequences of weight loss after gastric banding. Obes Surg 2001; 11: 455–458.
• 22) Adolfsson B, Elofsson S, Rossner S, Unden AL. Are sexual dissatisfaction and sexual abuse associated with obesity? A population-based study. Obes Res 2004; 12: 1702–1709.
• 23) Pace, G., V. Silvestri, L. Guala, and C. Vicentini. Body mass index, urinary incontinence, and female sexual dysfunction: how they affect female postmenopausal health. Menopause. 2009 16(6):1188-1192.
• 24) Huang, AJ, Stewart AL, Hernandez H. Shen, L.L. Subak. . Sexual function among overweight and obese women with urinary ıncontinence in a randomized controlled trial of an ıntensive behavioral weight loss ıntervention. Journal of Urology. 2009 181(5):2235-2242.
• 25) Bilgic D1, Gokyildiz S2, Kizilkaya Beji N3, Yalcin O4, Gungor Ugurlucan FQuality of life and sexual functıon in obese women with pelvic floor dysfunction. Women Health. 2019 Jan;59(1):101-113.