Evaluation of coital incontinence by electronic questionnaire: prevalence, associations and outcomes in women attending a urogynaecology clinic

Abstract

Introduction and hypothesis: Coital incontinence is the involuntary leakage of urine during sexual intercourse and is divided into that occurring with penetration and that occurring with orgasm. Mechanisms of coital incontinence are poorly understood. The aim of this retrospective study was to measure the prevalence of coital incontinence and evaluate the association among various types of coital incontinence with stress urinary incontinence (SUI), overactive bladder (OAB) and impact on quality-of-life in women attending a urogynaecology clinic. Methods: A total of 2,312 women completed the electronic Personal Assessment Questionnaire-Pelvic Floor (ePAQ-PF) in advance of their urogynaecology consultation. Logistic regression and Spearman’s rank-order correlation evaluated associations between types of coital incontinence and OAB and SUI. The Mann–Whitney test evaluated the relationship between coital incontinence and self-reported quality of sex life and self-avoidance and partner avoidance of sex. Subgroup analysis analysed outcomes in 84 women with coital incontinence undergoing treatment with tension-free vaginal tape (TVT). Results: Prevalence of coital incontinence in the cohort was 30%. Symptoms of OAB (p < 0.005) and SUI (p < 0.005) were significantly and independently associated with both types of coital incontinence (orgasm and penetration). In women with coital incontinence compared with those without, there was significant self-avoidance of sex (p < 0.0005), partner avoidance of sex (p < 0.0005) and impaired quality of sex life due to sexual problems (p < 0.005). The impact of this was significant in each group. Subgroup analysis of 84 women undergoing TVT showed significant improvement in all coital incontinence symptoms 3 months post-operatively. Conclusion: Using an electronic questionnaire before consultation has identified coital incontinence to be a prevalent symptom, having a significant impact on the patient’s sex life. Coital incontinence at orgasm and penetration are both significantly associated with SUI and OAB.