Female sexual function and urinary incontinence

Abstract

The aim of this thesis was to evaluate the intriguing and relevant relationship between UI and FSD in urological practice. This relationship is addressed from anatomical, clinical and health care points of view. The initial question was whether urologists should play a role in sexual health care of women with urinary incontinence. In chapter 2, three-dimensional anatomical econstructions and results of dissection in cadavers are described. The reconstructions illustrate the clitoral innervation in order to deduce its anatomical relationship to other pelvic structures. This is important to preserve clitoral nerves during pelvic surgery. Furthermore, this chapter evaluates the possible effects of incontinence surgery from an anatomical point of view, especially with regards to the nerves important for sexual function. In chapter 3, sexual function is evaluated among women after a sling procedure. This study attempts to clarify the impact of surgery for stress urinary incontinence on female sexual function. In addition, the relevance of the presence of preoperative coital incontinence is discussed extensively. Chapter 4 discusses the impact of female urinary incontinence on the sexual relationship with male partners. The chapters 5 and 6 overview practices, attitudes and believes of Dutch urologists towards FSD and sexual abuse. Chapter 7 analyses how Dutch incontinence nurses deal with sexuality and sexual abuse in their daily practice. Finally, chapter 8 provides a __helicopter view__ on data of this of this thesis followed by a discussion on future prospects.