Effects of pelvic floor muscle training on female sexual function in women with stress urinary incontinence: a controlled observational study
Female sexual function in women with stress urinary incontinence
Participants were prospectively recruited. SUI was diagnosed based on patient-reported symptoms and clinical evaluation. Women were considered to have SUI if they reported involuntary urine leakage during physical exertion, coughing, sneezing, or other activities that increase intra-abdominal pressure in the absence of urgency. The diagnosis was confirmed by physical examination, including a positive cough stress test, and supported by objective measures such as pad testing. To identify eligible participants, women with female sexual dysfunction were required to report associated sexual distress. Participants who declined conservative treatment for SUI—either because they did not perceive a need for treatment or preferred surgical management at a later stage—were allocated to the control group. Participants were divided into two groups: a control group of women who declined conservative treatment and an intervention group that completed a 12-week pelvic floor muscle training (PFMT) programme. The PFMT intervention included four supervised biofeedback sessions, individualised instruction, home exercises, and weekly clinic visits to monitor technique and adherence. Outcomes were measured at baseline and after 12 weeks. These included urinary leakage using the one-hour pad test, pelvic floor muscle strength and endurance using the Peritron perineometer, and sexual function and distress using the Female Sexual Function Index (FSFI) and Female Sexual Distress Scale-Revised (FSDS-R) questionnaires.
1. Stress urinary incontinence (SUI) 2. Sexually active women 3. Female sexual dysfunction (according to FSFI and FSDS-R questionnaires) 4. Adults 5. Willingness to comply with the study protocol 6. Ability to complete voiding diaries and questionnaires 7. Participants who declined conservative treatment for SUI—either because they did not perceive a need for treatment or preferred surgical management at a later stage—were allocated to the control group
1. Clinical evidence of urgent urinary incontinence 2. Neurogenic bladder dysfunction 3. Urinary retention or women considered at risk for these conditions 4. Previous pelvic floor muscle training, pelvic organ prolapse beyond stage I, prior surgery for urinary incontinence or pelvic organ prolapse 5. Neurological disorders 6. Active urinary tract infection