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Table 2 Effect of non-surgical treatments for urinary incontinence on sexual function

From: Impact of urinary incontinence on female sexual health in women during midlife

Study Study Design N Treatment Treatment Length Instrument Findings
Sexual Function Coital Incontinence
Pelvic Floor Muscle Training (SUI)
Bo et al [48] Randomized controlled trial 1. PMFT: 25 PMFT 6 months B-FLUTS • Non-significant improvement in pain, urinary-related sexual problems • Improved
2. Control: 30
Zahariou et al [49] Prospective case series Total: 58 PFMT 12 months FSFI • Improvement in FSFI and subscale scores (p < 0.05) • Improved (p < 0.005)
Pelvic Floor Muscle Training (UUI)
Wang et al [50] RCT 1. PFMT: 34 1. PFMT 12 weeks KHQ: Personal Relationship Domain • Non-significant improvement in Personal Relationship Domain in biofeedback-assisted PFMT group N/A
2. Biofeedback-assisted PFMT: 34 2. Biofeedback-assisted PFMT
3. Transvaginal electrical stimulation: 35 3. Transvaginal electrical stimulation
Anti-incontinence Pessary (SUI)
Handa et al [52] Randomized controlled trial 1. Continence pessary: 149 1. Continence pessary 12 months SPEQ (3 domains), PISQ-12 Responders (vs. non-responders): • Improved (p = 0.0002)
2. Behavioral therapy: 146 2. PMFT • PISQ improved (p = 0.007) • Greater improvement
3. Combo: 150 3. Combination • Restriction of sex due to UI improved (p = 0.008) • with combo therapy (p = 0.019) and behavioral (p = 0.02) vs. pessary alone
• Dyspareunia improved (p = 0.017)
Transvaginal electrical stimulation (SUI and UUI)
Giuseppe et al [51] Prospective case series Total: 23 Transvaginal electrical stimulation 3 months FSFI Significant improvement in FSFI and all subscale scores (p ≤ 0.01) except arousal, orgasm N/A
SUI: 8
UUI: 10
MUI: 5
Anti-cholinergic medication (UUI)
Sand et al [53] RCT Total: 2878 1. Patient education & transdermal oxybutynin 12 weeks KHQ: Personal Relationship Domain Significant improvement in KHQ score, bladder pain, effect of OAB on sex life, interest in sex Improved
Female: 2508 2. Transdermal oxybutynin only
Rogers et al [54] RCT 1. Placebo: 189 1. Placebo 12 weeks PISQ Significant improvement of PISQ and domain scores after 12 weeks N/A
2. Tolterodine: 188 2. Tolterodine 4 mg ER daily    Stable but no continued improvement if used 12 additional weeks except in Physical domain
Danilova et al [58] Prospective case series 57 Trospium 15 mg three times daily 16 weeks Unknown Sexual dysfunction decreased N/A
Chapple et al [56] RCT 1. Placebo: 283 1. Placebo 12 weeks KHQ: Personal Relationship Domain Patients with OAB, total N/A
2. Fesoterodine 4/8 mg: 272 2. Fesoterodine 4 mg Statistically significant improvement in fesoterodine 8 mg (vs. placebo) (mean score change of -11.9 v -6.2, p < 0.05)
3. Tolterodine ER 4 mg: 290 3. Fesoterodine 8 mg Patients with both UUI & OAB:
4. Tolterodine ER 4 mg Statistically significant improvement intolterodine (vs. placebo) (-12.7 v -6.8, p < 0.05)
Percutaneous tibial nerve stimulation (UUI)
Eftekhar et al [59] RCT 1. Percutaneous tibial nerve stimulation and tolterodine 4 mg daily: 25 1. Percutaneous tibial nerve stimulation and tolterodine 4 mg daily 12 weeks FSFI Within each arm: N/A
2. Tolterodine 4 mg daily: 25 2. Tolterodine 4 mg daily    Significant improvement in FSFI and subscale scores after 12 weeks (p < 0.001)
Between arms:
No significant difference in FSFI, subscale scores
van Balken et al [60] Prospective case series Total: 121 Percutaneous tibial nerve stimulation 12 weeks NSF-9 Significant improvement in Satisfaction (p < 0.005), Frequency (p < 0.005), Orgasm (p < 0.05) N/A
Female: 76     No significant change in dyspareunia, lubrication
  1. B-FLUTS Bristol female lower urinary tract symptoms; FSFI Female sexual function index; PISQ-12 Short form pelvic organ prolapse-urinary incontinence sexual function questionnaire; PFMT Pelvic floor muscle training; RCT Randomized controlled trial; SA Sexual activity; SPEQ: Short form personal experience questionnaire