Aims of Study:
Our objective in this study is to determine the effects of pelvic floor muscle strength improvement and consequent betterment of urinary incontinence problems on the sexual functions of patients treated with pelvic floor rehabilitation.

Methods:
27 patients who have received pelvic floor rehabilitation treatment (i.e., electrical stimulation, bio-feedback, vaginal con therapy, pelvic floor exercises) during the last one year in the uro-gynaecology outpatient clinic of Department of Obstetrics and Gynaecology at Istanbul University Medical Faculty were included in the study. The women gave their consent to participate. All the cases were evaluated by the routine patient evaluation forms of the uro-gynaecology outpatient clinic and classified as having pelvic floor dysfunction. Questionnaires of patient history and related gynaecologic details as well as the sexual life particulars (i.e., the five dimensions of sexual activity: sexual desire, arousal, intercourse, orgasm, and resolution [1]) were completed in face-to-face interviews. Pelvic muscle strength was measured by perinometer while improvement in incontinence was determined by pad test [2].

Results:
The median age and parturition of the patients were 42.5±4.8 and 3.1±1.2, respectively. Prior to pelvic floor rehabilitation the mean pelvic muscle strength of the patients was 20.4±11.7, which, after the treatment, was observed to be 38.7±16.3. Likewise, following the incontinence treatment the number of positive ped tests dropped down to 13 as compared to 20, which had been found prior to the treatment. Out of 16 women who reported low sexual desire prior to the incontinence treatment, 10 indicated the continuation of the problem while 4 reported improvement, 1 a complete recovery to normal, and 1 higher sexual desire. 4 women had reported vaginal dryness in arousal stage which remained unchanged after the treatment. 9 women out of 14, who had pain during the intercourse, experienced lessening of pain, 3 reported no pain any more while the remaining 2 still had pain just as they had before the treatment. Out of 7 women who said that they had problem to reach climax, 5 still remained so while 2 reported improvement to reach orgasm. 3 of 4 women who experienced difficulty to reach climax before the incontinence treatment still had the same problem; 1 said that she began getting more pleasure from sex after the treatment. 1 woman, who had not problem to have orgasm, reported to have better orgasms after the incontinence treatment.

Conclusions:
Improvements in sexual desire, coitus stage, and reaching climax have been observed of women who received pelvic floor muscle rehabilitation; no change is seen in arousal and resolution stages of the sexual activity.

References:
[1] Mental Health Nursing the Nurse-Patient Journey, W.B. Sounders, London, p.879-908, 1996.
[2] Assessing the severity of urinary incontinence in women by weighing perineal pads. The Lancet, p.1128-1130, 1986.