Study design, materials and methods
With the approval of our IRB, a cross-sectional study between June to August 2024 in patients of our neurourological clinic was performed. All the patients were invited to answer ICIQ-FLUTSsex, ICIQ-MLUTSsex, ICIQ-LUTSQoL and Neurogenic bladder symptom score (NBSS). A correlation in order to evaluate between sexual and urinary symptoms by sex was made using Spearman analysis with a p<0.05 was performed.
Results
A total of 81 patients (57% women) were included been Parkinson’s disease, and multiple esclerosis the most reported diseases. Diabetes mellitus, smoking and obesity were reported in 13, 21.7, 19.5% for female and 22.8, 28.5, 42.8% in males (Table 1).The median points of NBSS by sex was 31 (1-66) vs 25 (4-59), divided by domiains incontinence 12.5 (0-24) vs 9 (0-25) storage and voiding 11 (1-21) vs 10 (1-22), consequences 8 (0-21) vs 10 (1-22), Question 24 2 (0-4) vs 2 (0-4) and ICIQ-LUTSQoL 53 (19-83) vs 53 (21-76) for women and men respectively.
ICIQ-MaleLUTS sex reported a median of 5 (0-10) points, being reduced rigidity and anejaculation 37.1 and 34% the most reported problems. ICIQ-FemaleLUTS sex reported 6.5 (0-13) points, being dyspaurenia and leakage during intercourse 21.7% and 19.5% the most reported problems.
A positive correlation between NBSS and ICIQ-MLUTSsex of 0.61(p<0.000). ICIQ- LUTSQoL and ICIQ-MLUTSsex of 0.64 (p<0.000). NBSS and ICIQ-FLUTSsex of 0.72
(p<0.000). ICIQ-LUTSQoL and ICIQ-FLUTSsex of 0.65 p<0.000; was found (Figure 1).
Interpretation of results
It was clear that a repot of neurologic lower urinary tract symptoms, has an impact in the sexual dysfunction so counseling for patients with NLUTD needs to incorporate a sexual assessment. Although there is a clear association between urinary and sexual dysfunction in this population, patients are less frequently asked about sexual history during clinic visits, probably underestimating sexual dysfunction (1).