OnabotulinumtoxinA detrusor injection improves female sexual function in women with idiopathic wet overactive bladder syndrome

Balzarro M1, Rubilotta E1, Braga A2, Bassi S1, Processali T1, Artibani W1, Serati M3

Research Type


Abstract Category

Overactive Bladder

Abstract 101
Open Discussion ePosters
Scientific Open Discussion ePoster Session 7
Wednesday 29th August 2018
12:20 - 12:25 (ePoster Station 4)
Exhibition Hall
Urgency Urinary Incontinence Surgery Sexual Dysfunction Detrusor Overactivity Overactive Bladder
1. Dept. of Urology Azienda Ospedaliera Universitaria Integrata of Verona. Piazzale Aristide Stefani 1, Verona, 37126, Italy., 2. Dept. of Dept. of Obstetrics and Gynecology, EOC - Beata Vergine Hospital, via Turconi 23, Mendrisio, 6850, Switzerland, 3. Dept. of Obstetrics and Gynecology, University of Insubria, via Ravasi 2, Varese, 21100, Italy.

Emanuele Rubilotta




Hypothesis / aims of study
The correlation between changes in sexual function and improvements in LUTD in patients treated with OnabotulinumtoxinA (onaBoNT-A) detrusor injection is unclear and limited only to women with neurogenic OAB. Aim of this study was to evaluate the impact of OnabotulinumtoxinA (onaBoNT-A) injection on sexual function in women undergoing this treatment for idiopathic wet overactive bladder (OAB).
Study design, materials and methods
This is a pilot three-center observational study including women affected by idiopathic wet overactive bladder refractory to standard conservative treatments and underwent onaBoNT-A injection. Sexuality was assessed using the Female Sexual Function Index (FSFI) Italian version.1 A 3-day voiding diary, OAB screener questionnaire (OAB-S), and the international consultation on incontinence questionnaire short form (ICIQ-sf) were completed before and 3 months after onaBoNT-A injection to evaluate OAB symptoms.
All the 32 enrolled patients were evaluable and included for statistical analysis. Mean age ws 53 y.o. (26-68 y.o.). None of the women had previous pelvic surgery.
These patients received 100U of onaBoNT-A. Significant improvement of many FSFI domains was found. Only desire and pain domains had no significant improvements. The FSFI total score showed a significant improvement (P 0.0008). Table 1 shows the results of the FSFI before and after treatment with onaBoNT-A injection. Clinical efficacy has been documented by voiding diaries, OAB-S scores, and ICIQ-sf scores (table 2). Correlation between UUI episodes and FSFI total score was statistically significant (r= -0.73; p=0.04) while no significant correlation was found between number of micturition and FSFI total score. Correlations between urinary symptoms and the FSFI before and after treatment with onaBoNT-A injection are listed in table 3.
Interpretation of results
We documented a significant correlation between the reduction of episodes of UUI and improvement of FSFI total score. Voiding diaries and questionnaires on urinary symptoms showed a significant improvement after onaBoNT-A injection. The most relevant urinary symptom reducing the sexual function was urge urinary incontinence. The positive effect exerted by onaBoNT-A injection on urinary symptoms may have had a positive impact on the psychological status of the patients. Hence, women with a better control on OAB symptoms may have had a more gratification in the sexual intercourse. A greater self-confidence in sexual intercourses related to a better control of urinary leakages can explain the FSFI domains improvement.
Concluding message
Women underwent OnaBoNT-A detrusor injection to treat wet OAB, showed an improvement in sexual function due to the significant correlation between the improvement of urinary urge incontinence and a better gratification of sexuality.
Figure 1
Figure 2
  1. Filocamo MT, Serati M, Li Marzi V, Costantini E, Milanesi M, Pietropaolo A, Polledro P, Gentile B, Maruccia S, Fornia S, Lauri I, Alei R, Arcangeli P, Sighinolfi MC, Manassero F, Andretta E, Palazzetti A, Bertelli E, Del Popolo G, Villari D. The Female Sexual Function Index (FSFI): linguistic validation of the Italian version. J Sex Med 2014;11(2):447-53
Funding None Clinical Trial No Subjects Human Ethics Committee Internal Ethics Committee Department of Urology AOUI Verona Helsinki Yes Informed Consent Yes