The Effect Of Overactive Bladder Treatment With Behavior Therapy On Female Sexual Function

Objective:1.To evaluate the impact of overactive bladder syndrome symptoms on female sexual function.2.To determine the effect of behavior therapy for OAB on the sexual function of women.Methods:1.79 patiens with OAB for treatment and 79 healthy women for physical examination from a 3A hospital of Fujian,were evaluated using Female Sexual Function Index(FSFI)for sexual function respectively.According to the presence of urge incontinence,women with OAB were also divided into wet and dry groups.2.After Institution Review Board approval,151 female subjects who met the entry criteria were randomized into two groups:(1)Taking tolterodine 2 mg twice daily alone,(2)Receiving behavior therapy and taking tolterodine 2 mg twice daily.The outcome was measured by means of OAB symptom severity(Overactive Bladder Symptom Score,OABSS),Bother Symptom of disease(Urinary Distress Inventory Short Form 6,UDI-6 and Patient Perception of Bladder Condition Measure,PPBC),female sexual function(Female Sexual Function Index,FSFI)and quality of life(Overactive Bladder Questionnaire Short Form,OAB-q SF)before treatment and after 3 months intervention.Result :1.To compare with healthy group,patients with OAB have lower score.FSFI median values in both groups scored as follows(controls vs.patients: MD �SE value): desire: 2.98�1.07 vs.2.27�0.96;arousal: 3.48�1.16 vs.2.32�1.44;lubrication: 4.60�1.13 vs.3.10�1.95;orgasm: 3.37�0.87 vs.2.63�1.04;sexual satisfaction: 3.58�1.02 vs.2.41�1.35 sexual pain: 3.58�1.02 vs.2.41�1.35 and total score 22.24�5.29 vs.15.59�7.47(P<0.001).Although scores of all domains of FSFI(desire,arousal,lubrication,orgasm,satisfaction,pain and total)in the OAB wet group were found to be higher than those in the control group,only arousal was found to be significantly different(P= 0.028).2.After 3 months,the combination intervention group had a significant reduce in OAB symptom severity(P< 0.001),UDI-6(P < 0.001),PPBC(P< 0.001),OAB-q SF bother scale(P< 0.001),and improvement in FSFI(P< 0.001),OAB-q SF quality of life scale(P< 0.001).The tolterodine alone group also had a significant reduce in OAB symptom severity(P< 0.001),UDI-6(P< 0.001),PPBC(P< 0.001),OAB-q SF bother scale(P< 0.001),and improvement in FSFI(P< 0.001),OAB-q SF quality of life scale(P< 0.001).When compared directly to the tolterodine alone group,the combination group after 3months had higher FSFI total(22.50�4.38 vs.20.30�4.18,P=0.003),in the sexual function domain of desire(3.47�0.88 vs.2.89�0.53,P<0.001),arose(3.72�1.02 vs.3.30�0.91,P=0.011),pain(4.16�1.09 vs.3.69�1.14,P=0.013),satisfaction(3.69�0.85 vs.3.20�0.85,P=0.001).Significant reduction in OABSS total(3.12�2.03 vs.3.93�1.52,P=0.007),frequency(0.23�0.42 vs.0.46�0.63,P=0.014),urgency(1.18�1.02 vs.1.59�0.72,P=0.005)were found.There was no significant difference between the two group on PPBC?UDI6?OAB-q SF?the sexual function domain of lubrication,orgasm,the symptom of nocturia and urge incontinence(P>0.05).Conclusion:Women with OAB had poor sexual function than healthy female.Both drug and combination therapies reduce OAB symptoms severity and improve the quality of life and female sexual function.The combination of behavior therapy brings better outcome.