A Polland, J Hamner, D Arunachalam, D Dwarica, A Gupta, J Pennycuff

(015) STOMP: Sexual function Trial of Overactive bladder: Medication versus PTNS

  • Urology
  • Reproductive Medicine
  • Endocrinology
  • Endocrinology, Diabetes and Metabolism
  • Psychiatry and Mental health
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Abstract Introduction Female sexual dysfunction affects approximately 45% of women, and an even greater percentage of those with overactive bladder (OAB). Sexual function, measured by the Female Sexual Function Index (FSFI), has been shown to improve with treatment of OAB. To date, no study has compared the effects of percutaneous tibial nerve stimulation (PTNS) versus medication (anticholinergics (ACH) or beta-agonists (BAG)) on sexual function. Objectives The objective of this study was to compare the effect of PTNS and medical therapy (MT) with ACH or BAG on female sexual function. Methods This was a prospective multi-center cohort study. Sample sizes of 63 per group were calculated to be necessary to detect a clinically relevant difference in the primary end point, FSFI. Sexually-active women with OAB completed the Overactive Bladder questionnaire (OAB-q), FSFI, Beck Depression Inventory and a visual analog pain scale prior to and after 12 weeks of therapy. Results 175 patients were recruited and 104 completed follow up (58/108 ACH, 31/49 BAG, 13/18 PTNS). The PTNS group had lower overall FSFI (p=0.04), worse pain (p=0.01) and decreased lubrication (p=0.006) compared to the BAG and ACH groups. After treatment there were no significant differences between the groups in overall or sub-domain FSFI scores. There were within-group FSFI differences from pre- to post-treatment, with a worsening of arousal in the ACH group (p=0.046) and an improvement in overall FSFI (p=0.04) and pain (p=0.04) with BAG. After treatment, postmenopausal women in the BAG group had significantly better overall FSFI (p=0.01), desire (p=0.003), arousal (p=0.009) and orgasm (p=0.01). Conclusions While both PTNS and MT improved OAB, ACH resulted in worsening of aspects of sexual function, such as arousal, while BAG improved overall sexual function and pain. Improvement in sexual function with treatment was pronounced in the sub-group of postmenopausal women. While further research in necessary, this study provides additional information about the comparative effects of OAB treatments on female sexual function, which may ultimately lead to better patient selection and outcomes. Disclosure No.

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