(661) Voiding Disorders in Women with a History of Childhood and Adolescent Sexual Abuse

Introduction Women with a history of sexual abuse during childhood or adolescence frequently report lower urinary tract symptoms (LUTS) and pelvic floor dysfunction. Diagnostic evaluation and treatment in such cases are often challenging due to the complexity of somatic and psychological factors. Objective This study aimed to investigate voiding function in women with and without a history of sexual abuse during childhood or adolescence using validated questionnaires, uroflowmetry combined with pelvic floor electromyography (EMG), and post-void bladder ultrasound. Methods 40 women undergoing inpatient/psychosomatic day clinic treatment for post-traumatic stress disorder (PTSD) were prospectively recruited, of which 20 women reported sexual abuse during childhood or adolescence. All participants completed validated questionnaires, including the German Pelvic Floor Questionnaire, the Female Sexual Function Index (FSFI), and the PTSD Checklist for DSM-5 (PCL-5). In addition, they underwent uroflowmetry with concurrent pelvic floor electromyography (EMG) and post-void residual urine assessment by ultrasound. Results The mean age of participants was 45.5 ± 12.2 years (range 22–64). Women with a history of sexual abuse during childhood or adolescence showed significantly poorer pelvic floor function, particularly regarding bladder and sexual function (p < 0.05). Compared to women without a history of sexual abuse during childhood or adolescence, they more frequently reported weakened urinary stream, forced voiding, urgency, and painful micturition (p < 0.05). No significant differences were found in voided volume, maximum flow, or average flow rates between groups. Normal voiding patterns were observed in 50% and 70% of women with and without a history of sexual abuse during childhood or adolescence, respectively, whereas obstructive voiding occurred in 30% of both groups. Detrusor-sphincter-dyssynergia was identified in 20% (n=4) of the women with sexual abuse history during childhood or adolescence but in none of the women without sexual abuse history during childhood or adolescence. Conclusions The findings suggest an association between voiding dysfunction and preexisting sexual trauma during childhood or adolescence. Uroflowmetry with simultaneous pelvic floor EMG and post-void residual urine assessment enables the identification of potentially treatable urological conditions, although little is known about a causal mechanism potentially explaining these association. This descriptive pilot study provides initial objective data and highlights the need for further interdisciplinary research. Disclosure No