Female Sexual Function after Surgical Treatment of Urinary Incontinence

Introduction: Urinary incontinence is a common problem that can affect the quality of life of women of all ages and can negatively influence the exercise of sexuality. Aim: The aim of this study was to compare sexual function of women before and after surgical treatment for urinary incontinence. Method: The sample consisted of 38 women with urinary incontinence and surgical treatment (Burch or Sling procedure). The Female Sexual Function Index (FSFI) was used to evaluate sexual dysfunction before and after surgical treatment. Results: The mean age of the women in the study was 48 ± 8.8 years, and 58% were 50 years old or younger. By analyzing FSFI, it was observed that the majority of subjects had an overall index of sexual dysfunction (score < 26 points) before surgery. The desire and arousal domains improved significantly after surgery for all women included in the study. It was also observed that women with higher levels of education had more positive results related to desire. Conclusions: In our sample, in general, sexual function improved after surgical treatment of urinary incontinence, regardless of technique used, particularly in the discounter and pain domain. There was a substantial improvement of the sexual function among women who had presented with cystocele. Desire and arousal improved significantly after surgery, very likely due to the improvement of self-esteem after surgery.

Sexual Function in Pregnant Women in the Public Health System

Introduction: Pregnancy is a unique situation and involves changes in sexuality. The aim is to evaluate sexual function and satisfaction in pregnant women under prenatal care provided by the public health system. Method: Cross-sectional study with pregnant women receiving ambulatory care in the public health system in the Southern region of Brazil conducted between November 2014 and September 2015. Results: 283 pregnant women were studied. The mean age was 27.7 ± 6.3 years;64% were white and 31.1% were nulliparous. In the total sample, 8.50% were in the first trimester of pregnancy, 37.4% were in the second trimester, and 54.1% were in the third trimester. The rate of global sexual dysfunction (score 26 points) was 55.5%, following the application of The Female Sexual Function Index (FSFI). Sexual dysfunction was significantly more prevalent in the third trimester (62%) compared to the first (33.3%) and second (50.9%) trimesters (p = 0.015). There was a significant difference in all domains, except in the desired domain, according to the trimester. Pregnant women in the third trimester showed significantly lower scores compared to those in the first trimester in the domains with significance. Conclusion: The prevalence of sexual dysfunction among pregnant women in the public system was high. Knowing that more than 50% of the pregnant women presented sexual dysfunction, it is essential to approach sexuality during prenatal care involving the couple.

Profile of Female Patients at a Sexology Ambulatory in the Brazilian Public Health System

Introduction: Sexual problems are fairly common, and sexuality is an important parameter of health and quality of life. However, only a few centers in Brazil have ambulatories specialized in sexual dysfunction. This study was conducted in a service that is a state reference for these pathologies. Methods: This study was conducted at the human sexuality ambulatory of a large public hospital in southern Brazil. It was a cross-sectional descriptive study with women attending at the first medical visit to the ambulatory of human sexuality in a period of four years. Female Sexual Function Index (FSFI) questionnaires with both qualitative and quantitative questions were applied in all first medical visits to the ambulatory. Results: The 153 women attending had a mean age of 40.9 (±12.9) years. The most frequent complaint was “lack of desire” (56.8%), followed by pain in intercourse (25.4%) and lack of pleasure or inability to achieve orgasm (12.4%). The prevalence of sexual dysfunction (FSFI cut-off score < 26.5) was 74.5%. The patient’s age, the age of the partner, and the length of the relationship with the partner had a significant correlation with a lower FSFI score. There was an inverse correlation between the length of the relationship and the FSFI score. The self-attributed score for satisfaction with sexual life had a significant correlation with the FSFI total score (r = 0.708, p 0.01). Conclusion: We conclude that women who seek care in sexuality are in the perimenopausal period and that factors such as the number of children, age of menopause and length of the relationship have a negative influence on sexuality. The score for the self-assessment of sexuality could serve as an initial screening for sexual dysfunction, since it is quick and easy to apply in routine medical visits. However, more studies are required to compare the FSFI and this score.