Partnered sexual activity and satisfaction in women with spinal cord disease: influence of urinary incontinence and other predictors

Abstract Study design Cross-sectional study. Objectives Evaluate sexual activity and satisfaction in women with spinal cord disease (SCD) and their associations with urinary incontinence. Setting Outpatient neuro-urology clinics at a tertiary rehabilitation center in Brazil. Methods Ninety-eight women aged ≥18 years with traumatic or non-traumatic SCD were included. Clinical and demographic data were collected through structured interviews. Bladder symptoms were assessed with the Neurogenic Bladder Symptom Score–Short Form (NBSS-SF). Sexual function was evaluated with the Female Sexual Function Index (FSFI), and sexual satisfaction with the WHOQOL-BREF. Sexual activity was defined as partnered sexual activity, with or without intercourse, within the prior six months. Logistic regression identified predictors of sexual activity and satisfaction. Results Mean age was 42.9 (±12.1) years; most cases were non-traumatic (85.7%), mainly multiple sclerosis (55.9%). Urinary incontinence was reported by 52%, severe in 28.6%. Sexual activity was reported by 48 women (49.0%), of whom 58.3% had FSFI-defined dysfunction and 60.4% reported satisfaction. Incontinence was strongly associated with inactivity (72.5% vs. 27.5%, p < 0.001) and lower FSFI scores (16.2 (10.3) vs. 24.4 (9.1), p < 0.001). Urinary continence (OR 5.0, 95% CI, 1.7 to 14.4), younger age (OR 0.93/year, 95% CI, 0.89 to 0.98), and being married (OR 10.9, 95% CI, 3.6 to 33.3) predicted sexual activity and satisfaction. Conclusions Sexual dysfunction and UI were prevalent and interrelated in women with SCD. UI independently predicted inactivity and dissatisfaction.