Bladder pain syndrome associated with highest impact on sexual function among women with lower urinary tract symptoms

Objective To investigate the differential impact of lower urinary tract symptoms (LUTS) on female sexual function (FSF). Methods In a cross-sectional study in Agostino Gemelli Hospital, Rome, Italy, 188 sexually active patients with LUTS, as assessed by self-reported questionnaires, underwent comprehensive urologic and urodynamic examination between January 2008 and December 2010. Patients with urinary incontinence, voiding-phase LUTS, overactive bladder (OAB), and bladder pain syndrome (BPS) were included. FSF was assessed by PISQ-12 questionnaire, and scores (0–100; higher scores indicate worse FSF) were compared between the patients and a group of age-matched women without LUTS. PISQ-12 scores of different clinical and urodynamic patient subgroups were also compared by multivariate analysis. Results The global PISQ-12 mean score was significantly higher among patients with LUTS (32.7) than among controls (18.4; P < 0.0001). Women with BPS reported the highest global PISQ-12 score (46.1), followed by those with urodynamic detrusor overactivity (45.0), clinical urgency (41.4), mixed (37.7) and stress urinary incontinence (28.1), dry OAB (22.2) and voiding-phase LUTS (19.6). Age, urinary incontinence, BPS, and detrusor overactivity were independent predictors of FSF. Conclusion BPS was associated with the greatest impairment of FSF among women with LUTS. Clinical and urodynamic urgency-type urinary incontinence affected FSF more markedly than other types.