Study design, materials and methods
This is retrospective analysis of a prospective study, namely Chinese validation of Pelvic Floor Distress Inventory (PFDI) and Pelvic Floor Impact Questionnaire (PFIQ). All Chinese women presented to the Urogynaecology clinic for PFD were recruited. Written consent was obtained. Demographic data including their sexual activity status, being sexually active or inactive, and co-morbidity of diabetes mellitus and hypertension, were collected. They filled in the Chinese PFDI and PFIQ to determine their symptoms and bothersome of PFD. Gynaecological examination was performed and stage of pelvic organ prolapse (POP) was assessed by pelvic organ prolapse quantification (POP-Q). Ethics approval was obtained.
Results
In all, 597 women were recruited; 529 (88.6%) provided the information on sexual status. The mean age of these women was 54.5±11.1 years (range 23-87 years) and parity was 2.6±1.4. Among them, 292 (55.2%) had urinary incontinence or other urinary symptoms only, 167 (31.6%) had both urinary incontinence and POP, 56 (10.6%) had POP only, followed by 12 (2.3%) had urinary and fecal incontinence and 2 (0.3%) had urinary and fecal incontinence and POP. The characteristics of the women were listed in table 1.
Table 2 showed the factors associated with the sexual status of women. Higher age, being menopause, hypertension, symptoms of POP and more advanced stage of POP were factors predicting women who were sexually inactive. Urinary incontinence and coital incontinence did not predict women being sexually inactive. PFDI scores and having diabetes mellitus were not associated with the sexual status. However, after multivariate analysis, only higher age was an independent factors for women being sexually inactive (OR 0.9, 95% CI 0.87-0.93, P<0.005), while women who had a higher parity was an independent factor for being sexually active (OR 1.3, 95% CI 1.04-1.62, P=0.02).
Interpretation of results
Although higher age, symptoms of POP, more advanced stage of POP, menopausal status and co-morbidity of hypertension were associated with sexually inactivity of women, only higher age was an independent factor (OR 0.9). Having coital incontinence did not affect women being sexually inactive. PFDI scores were not associated with sexual activity of women.