Female Urinary Incontinence During Sexual Intercourse (Coital Incontinence): A Review

Urinary incontinence (UI) is common and occurs in approximately 20% of the general female population, but it approaches 35% in women older than 60 years.1 The condition adversely affects quality of life (QoL), including social and sexual function.2 As American women age, the prevalence of pelvic floor disorders, such as UI, is also expected to increase.3 No less significant, sexual dysfunction is also common among women, with a reported rate of 43% in a study of adult sexual behavior.4 The American Foundation for Urological Disease categorizes female sexual dysfunction into 4 types: low libido, difficult arousal, difficulty with orgasm, and dyspareunia.5 Not surprisingly, sexual complaints among women seeking treatment for pelvic floor disorders such as UI approach 50%.6 Coital incontinence (CI) is urinary leakage that occurs during either penetration or orgasm and can occur with a sexual partner or with masturbation. It has been reported to occur in 10% to 24% of sexually active women with pelvic floor disorders, yet CI may still be an underreported problem since sexual or urinary dysfunction may not be often or readily discussed due to patient or physician embarrassment.7 Unfortunately, CI can have a disturbing impact on QoL and sexuality. Women rarely refer to it spontaneously, with only 3% of women self-reporting sexual disorders including CI; even with direct questioning, only 20% will admit to it.8 The impact on QoL from CI is significant. Sexually active women with CI reported a worse QoL than those without it.9 More emphasis should be placed on CI as a relevant urinary and sexual complaint.10