Abstract

ntroduction: Coital urinary incontinence (CI) is a common symptom among patients who consult specialized clinics for pelvic floor pathology. Their prevalence can range from 1 to 66% depending on the definition used and the group studied. In Chile, 24% prevalence has been deter- mined in urogynecological patients. It has also been shown to be associ- ated with symptoms of urgency, enuresis and a sensation of a large vagi- na, and is itself capable of causing detriment on sexual function and sexual satisfaction. Post orgasm CI has traditionally been defined as in- voluntary leakage of urine immediately after orgasm and has been asso- ciated with symptoms of urinary urgency, although the physiopathologi- cal mechanism of both types of IC has not been elucidated. Some authors argue that CI at penetration would be associated with stress symptoms and post orgasm CI with urgency. It is therefore necessary to understand whether we are faced with two different pathologies. Material and Methods: Retrospective cross-sectional observational study. Population and sample: Patients admitted to the polyclinic of a public hospital urogynecology unit from January 2013 to July 2017 (1331 women). Two randomised groups were established for comparative analysis, according to the presence of post-orgasm CI (n=39) or CI at any time (n=46); all patients consulted for urinary incontinence or pelvic organ prolapse. Exclusion criteria: other types of incontinence than stress, mixed and overactive bladder incontinence. Data analysis: Descriptive through absolute and relative frequencies. Bivariate analysis with chi- square test and Mann Whitney. P<0.05 was set for statistical significance. SPSS 19.0 software. Results: 2.9% of all patients had isolated post orgasmic IC. Average age of this group was 52.5 years old compared to 50.7 in the other group (p=0.43). There was no difference in the type of incontinence associated (p=0.484), presence of enuresis (p=0.98), nicturia (p=0.279), sensation of a large vagina (p=0.088), dyspareunia (p=0.888), parity (p=0.434), birth canal (p=0.261), diabetes (p=0.497) or constipation (p=0.193). The aver- age reported voiding frequency was 6.3 in the post orgasmic group versus 8.2 in the other group (p=0.0098). Conclusions: Patients with postorgasmic IC have no different associa- tions from patients with coital incontinence that occurs at any other time during sexual intercourse, so it could be inferred that it does not constitute a different entity. We assume that the difference recorded in urinary fre- quency is due to the common error of self-reporting, although it is nec- essary to re-evaluate this topic with a larger group of patients or with the results of a urinary diary