Effect of flatal incontinence on sexual function

Objective: To determine whether flatal incontinence (FI) adversely affects sexual function. Methods: A database of 1203 women presenting to a consultative urogynecology practice was queried. The Pelvic Floor Distress Inventory Short Form (PFDI-20) and Pelvic Organ Prolapse/Urinary Incontinence Sexual Function (PISQ-12) questionnaires were administered on presentation to the practice. Flatal incontinence was identified by an answer of at least "somewhat" to question 11 of PFDI-20. Questions 9 and 10 were used to eliminate confounding effects of leakage of solid and liquid stool. Univariate analyses were performed using Student t and Ξ² tests. Results: Of the 1076 women who answered PFDI-20 question 11, 485 subjects (46.2%) were FI and 591 (54.9%) were not flatally incontinent (NFI). The PFDI-20 global and all 3 subscores were higher in the FI than in the NFI group. Sexual activity was reported in 47.8% of subjects with FI and in 60.2% of the NFI group (P G 0.001). Among those who were sexually active, PISQ-12 scores were significantly higher in the FI group (n = 219, 15.8 ± 6.4 vs n = 334, 14.4 ± 5.9, P = 0.006). After sexually active subjects with incontinence to stool were excluded, PFDI-20 and PISQ-12 scores were compared. Those with FI had significantly higher PFDI-20 global and subscores, but there was no significant difference in PISQ-12 scores (FI: 14.8 ± 6.2 vs NFI: 14.0 ± 5.7, P = 0.161). Conclusions: Flatal incontinence is associated with decreased sexual activity and impaired sexual function. Flatal incontinence not accompanied by incontinence to stool, however, may not worsen sexual function.