Association of Vulvar Symptoms with Pelvic Organ Prolapse and Urinary Incontinence

Abstract

Objective The aim of this study was to compare vulvar symptoms between urogynecology patients diagnosed with urinary incontinence (UI) and/or pelvic organ prolapse to women presenting for annual gynecological care. Methods This is a retrospective cross-sectional study. Vulvar symptoms (burning, pain, itching, dyspareunia, and discharge) were measured by asking respondents to rate the severity of each symptom from 0 (none) to 10 (most severe). Patient history, diagnoses, and the Urogenital Distress Inventory-6 (UDI-6) score were abstracted from records. Vulvar symptom results were categorized (0, none; 1-3), mild; ≥4, moderate to severe). Logistic regression models explored whether UI symptoms (UDI-6) and urogynecology diagnoses were associated with each vulvar symptom (moderate to severe vs none). Results A total of 606 urogynecology patients grouped by the following urogynecology clinical diagnoses: UI (n = 230), prolapse (n = 193), UI + prolapse (n = 183), and 258 controls (general gynecology patients) were included. The mean (± SD) age (years) was 57.5 ± 16.1, 62.4 ± 13.9, 59.0 ± 14.9, and 41.3 ± 13.8 in the UI, prolapse, UI + prolapse, and control groups, respectively (p < 0.05 for all). Prolapse and UI + prolapse diagnoses (compared with controls) were associated with vulvar burning (OR [95% confidence interval {CI}], 2.5 [1.2-5.0] and 2.9 [1.3-6.1] and pain (OR (95% CI), 3.6 [1.5-8.5] and 3.3 [1.4-8.2], respectively). Prolapse diagnoses were also associated with dyspareunia (OR [95% CI], 5.4 [2.2-13.3]). Conclusions Patients with pelvic organ prolapse are more likely to report vulvar burning, pain, and dyspareunia than gynecologic control patients. Urinary symptoms were associated with all vulvar symptoms.