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Female Urinary Incontinence During Sexual Intercourse (Coital Incontinence): A Review
The Female Patient, 07/31/09

Karlovsky ME – CI is a result of underlying pelvic floor dysfunction whose etiologies are multifactorial. Well–known risk factors for SUI and OAB include genetic predisposition, race, pregnancy and vaginal birth, age and menopause, hysterectomy, obesity, chronic cough, and constipation. All women should be screened for CI in addition to other aspects of sexual dysfunction. After a diagnosis of CI is made, whether orgasm– or penetration–related, urodynamics can be performed in the background of a comprehensive work–up to determine an appropriate treatment plan. Review of other sexual dysfunction is also recommended. PFM training and conservative treatments are always the first line of therapy for either form of CI, with the addition of OAB medication for CI from orgasm. Surgical treatment is available for incontinence with penetration as a cure for SUI in general and has been demonstrated to also help incontinence with orgasm. Unfortunately, no matter the treatment modality, the overall cure rates are slightly lower when compared with women with SUI/OAB but no CI, illustrating the more severe nature of CI. All female sexual domains appear improved after treatment of CI.

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