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International Urogynecology Journal

, Volume 30, Issue 11, pp 1807–1816 | Cite as

The negative effect of urologic chronic pelvic pain syndrome on female sexual function: a systematic review and meta-analysis

  • Yupeng Guan
  • Gang Yu
  • Guoren Wang
  • Zhiming BaiEmail author
Review Article

Abstract

Introduction and hypothesis

To explore the effect of urologic chronic pelvic pain syndrome (UCPPS) on female sexual function.

Methods

Database searches were conducted in PubMed, EMBASE, the Cochrane Library, and Google Scholar for published literature using the Female Sexual Function Index (FSFI) or reporting the prevalence of dyspareunia. Data extraction and quality evaluation were performed on the literature that met the inclusion criteria, and a meta-analysis was performed using STATA 12.0 and RevMan5.3 software to calculate the mean differences (MD) and odds ratios (OR) and their 95% confidence intervals (CI).

Results

A total of nine case-control studies enrolling 4965 subjects were investigated. The present meta-analysis results demonstrated a strong correlation between UCPPS and dyspareunia (OR = 11.27, 95% CI: 5.15–24.67, P < 0.00001). The UCPPS group had significantly lower scores in each domain of the FSFI compared with the healthy control group: total score (MD = −11.35, 95% CI: −14.54– − 8.16, P < 0.00001); desire (MD = −1.04, 95% CI: −1.20– − 0.88, P < 0.00001); arousal (MD = −1.78, 95% CI: −2.36– − 1.20, P < 0.00001); lubrication (MD = −2.11, 95% CI: −2.49– − 1.73, P < 0.00001); orgasm (MD = −1.50, 95% CI: −1.72– − 1.28, P < 0.00001); satisfaction (MD = −1.54, 95% CI: −1.97– − 1.12, P < 0.00001); pain (MD = −2.89, 95% CI: −3.63– − 2.14, P < 0.00001).

Conclusions

UCPPS had a significantly negative effect on female sexual function, particularly in the lubrication, pain, and total score domains. In addition, UCPPS patients had a significantly higher risk of dyspareunia. Psychosocial variables may be a potential pathogenesis of female sexual dysfunction (FSD). Future well-designed research is called for to develop a comprehensive estimate of the association between UCPPS and FSD.

Keywords

Urologic chronic pelvic pain syndrome Female sexual dysfunction Female Sexual Function Index Dyspareunia Meta-analysis 

Notes

Acknowledgments

We thank Prof. Zhihai Qin for his linguistic assistance and suggestions to improve the manuscript. We thank Prof. Hairong Huang for her assistance with the statistical aspects.

Funding

This study was funded by grants from the Natural Science Foundation of Hainan Province (no. 20158296).

Compliance with ethical standards

Conflicts of interest

None.

References

  1. 1.
    Landis JR, Williams DA, Lucia MS, Clauw DJ, Naliboff BD, Robinson NA, et al. The MAPP research network: design, patient characterization and operations. BMC Urol. 2014;14:58.  https://doi.org/10.1186/1471-2490-14-58.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Rosen R, Brown C, Heiman J, Leiblum S, Meston C, Shabsigh R, et al. The female sexual function index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital Ther. 2000;26(2):191–208.  https://doi.org/10.1080/009262300278597.CrossRefPubMedGoogle Scholar
  3. 3.
    Wiegel M, Meston C, Rosen R. The female sexual function index (FSFI): cross-validation and development of clinical cutoff scores. J Sex Marital Ther. 2005;31(1):1–20.  https://doi.org/10.1080/00926230590475206.CrossRefPubMedGoogle Scholar
  4. 4.
    Stroup DF, Berlin JA, Morton SC, Olkin I, Williamson GD, Rennie D, et al. Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis of observational studies in epidemiology (MOOSE) group. JAMA. 2000;283(15):2008–12.CrossRefGoogle Scholar
  5. 5.
    Wells G, Shea B, O’Connell D, Peterson J, Welch V, Losos M, et al. The Newcastle-Ottawa scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. 2017. http://www.ohrica/programs/clinical_epidemiology/oxford.asp.
  6. 6.
    Gardella B, Porru D, Nappi RE, Dacco MD, Chiesa A, Spinillo A. Interstitial cystitis is associated with vulvodynia and sexual dysfunction—a case-control study. J Sex Med. 2011;8(6):1726–34.  https://doi.org/10.1111/j.1743-6109.2011.02251.x.CrossRefGoogle Scholar
  7. 7.
    Gardella B, Porru D, Ferdeghini F, Martinotti Gabellotti E, Nappi RE, Rovereto B, et al. Insight into urogynecologic features of women with interstitial cystitis/painful bladder syndrome. Eur Urol. 2008;54(5):1145–53.  https://doi.org/10.1016/j.eururo.2008.01.079.CrossRefGoogle Scholar
  8. 8.
    Nickel JC, Tripp DA, Pontari M, Moldwin R, Mayer R, Carr LK, et al. Psychosocial phenotyping in women with interstitial cystitis/painful bladder syndrome: a case control study. J Urol. 2010;183(1):167–72.  https://doi.org/10.1016/j.juro.2009.08.133.CrossRefPubMedGoogle Scholar
  9. 9.
    Warren JW, Clauw DJ, Wesselmann U, Langenberg PW, Howard FM, Morozov V. Sexuality and reproductive risk factors for interstitial cystitis/painful bladder syndrome in women. Urology. 2011;77(3):570–5.  https://doi.org/10.1016/j.urology.2010.10.018.CrossRefPubMedGoogle Scholar
  10. 10.
    Zaslau S, Riggs DR, Perlmutter AE, Jackson BJ, Osborne J, Kandzari SJ. Sexual dysfunction in patients with painful bladder syndrome is age related and progressive. Can J Urol. 2008;15(4):4158–62.PubMedGoogle Scholar
  11. 11.
    Zondervan KT, Yudkin PL, Vessey MP, Jenkinson CP, Dawes MG, Barlow DH, et al. Chronic pelvic pain in the community—symptoms, investigations, and diagnoses. Am J Obstet Gynecol. 2001;184(6):1149–55.  https://doi.org/10.1067/mob.2001.112904.CrossRefPubMedGoogle Scholar
  12. 12.
    Ottem DP, Carr LK, Perks AE, Lee P, Teichman JM. Interstitial cystitis and female sexual dysfunction. Urology. 2007;69(4):608–10.  https://doi.org/10.1016/j.urology.2006.12.024.CrossRefPubMedGoogle Scholar
  13. 13.
    Peters KM, Killinger KA, Carrico DJ, Ibrahim IA, Diokno AC, Graziottin A. Sexual function and sexual distress in women with interstitial cystitis: a case-control study. Urology. 2007;70(3):543–7.  https://doi.org/10.1016/j.urology.2007.04.037.CrossRefPubMedGoogle Scholar
  14. 14.
    Schrepf A, O'Donnell M, Luo Y, Bradley CS, Kreder K, Lutgendorf S. Inflammation and inflammatory control in interstitial cystitis/bladder pain syndrome: associations with painful symptoms. Pain. 2014;155(9):1755–61.  https://doi.org/10.1016/j.pain.2014.05.029.CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Yoon HS, Yoon H. Correlations of interstitial cystitis/painful bladder syndrome with female sexual activity. Korean J Urol. 2010;51(1):45–9.  https://doi.org/10.4111/kju.2010.51.1.45.CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Lee M-H, Chen W-C, Chiu C-D, Wu H-C. Dyspareunia and chronic pelvic pain in patients with interstitial cystitis/bladder pain syndrome. Urol Sci. 2015;26(3):206–9.  https://doi.org/10.1016/j.urols.2015.07.004.CrossRefGoogle Scholar
  17. 17.
    Nickel JC, Parsons CL, Forrest J, Kaufman D, Evans R, Chen A, et al. Improvement in sexual functioning in patients with interstitial cystitis/painful bladder syndrome. J Sex Med. 2008;5(2):394–9.  https://doi.org/10.1111/j.1743-6109.2007.00686.x.CrossRefPubMedGoogle Scholar
  18. 18.
    Aaron LA, Herrell R, Ashton S, Belcourt M, Schmaling K, Goldberg J, et al. Comorbid clinical conditions in chronic fatigue: a co-twin control study. J Gen Intern Med. 2001;16(1):24–31.PubMedPubMedCentralGoogle Scholar
  19. 19.
    Heitkemper M, Jarrett M. Overlapping conditions in women with irritable bowel syndrome. Urol Nurs. 2005;25(1):25–30 quiz 31.PubMedGoogle Scholar
  20. 20.
    Kaya S, Hermans L, Willems T, Roussel N, Meeus M. Central sensitization in urogynecological chronic pelvic pain: a systematic literature review. Pain Physician. 2013;16(4):291–308.PubMedGoogle Scholar
  21. 21.
    Lai HH, Gardner V, Ness TJ, RWt G. Segmental hyperalgesia to mechanical stimulus in interstitial cystitis/bladder pain syndrome: evidence of central sensitization. J Urol. 2014;191(5):1294–9.  https://doi.org/10.1016/j.juro.2013.11.099.CrossRefPubMedGoogle Scholar
  22. 22.
    Woolf CJ. Central sensitization: implications for the diagnosis and treatment of pain. Pain. 2011;152(3 Suppl):S2–15.  https://doi.org/10.1016/j.pain.2010.09.030.CrossRefPubMedGoogle Scholar
  23. 23.
    Fall M, Baranowski AP, Elneil S, Engeler D, Hughes J, Messelink EJ, et al. EAU guidelines on chronic pelvic pain. Eur Urol. 2010;57(1):35–48.  https://doi.org/10.1016/j.eururo.2009.08.020.CrossRefPubMedGoogle Scholar
  24. 24.
    Rodriguez MA, Afari N, Buchwald DS. Evidence for overlap between urological and nonurological unexplained clinical conditions. J Urol. 2009;182(5):2123–31.  https://doi.org/10.1016/j.juro.2009.07.036.CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    Nickel JC, Shoskes D, Irvine-Bird K. Clinical phenotyping of women with interstitial cystitis/painful bladder syndrome: a key to classification and potentially improved management. J Urol. 2009;182(1):155–60.  https://doi.org/10.1016/j.juro.2009.02.122.CrossRefPubMedGoogle Scholar
  26. 26.
    Tonyali S, Yilmaz M. Sexual dysfunction in interstitial cystitis. Curr Urol. 2017;11(1):1–3.  https://doi.org/10.1159/000447186.CrossRefPubMedPubMedCentralGoogle Scholar
  27. 27.
    Clemens JQ, Mullins C, Kusek JW, Kirkali Z, Mayer EA, Rodriguez LV, et al. The MAPP research network: a novel study of urologic chronic pelvic pain syndromes. BMC Urol. 2014;14:57.  https://doi.org/10.1186/1471-2490-14-57.CrossRefPubMedPubMedCentralGoogle Scholar
  28. 28.
    Engeler DS, Baranowski AP, Dinis-Oliveira P, Elneil S, Hughes J, Messelink EJ, et al. The 2013 EAU guidelines on chronic pelvic pain: is management of chronic pelvic pain a habit, a philosophy, or a science? 10 years of development. Eur Urol. 2013;64(3):431–9.  https://doi.org/10.1016/j.eururo.2013.04.035.CrossRefPubMedGoogle Scholar
  29. 29.
    van de Merwe JP, Nordling J, Bouchelouche P, Bouchelouche K, Cervigni M, Daha LK, et al. Diagnostic criteria, classification, and nomenclature for painful bladder syndrome/interstitial cystitis: an ESSIC proposal. Eur Urol. 2008;53(1):60–7.  https://doi.org/10.1016/j.eururo.2007.09.019.CrossRefPubMedPubMedCentralGoogle Scholar
  30. 30.
    Lo CK, Mertz D, Loeb M. Newcastle-Ottawa scale: comparing reviewers’ to authors’ assessments. BMC Med Res Methodol. 2014;14:45.  https://doi.org/10.1186/1471-2288-14-45.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© The International Urogynecological Association 2019

Authors and Affiliations

  • Yupeng Guan
    • 1
  • Gang Yu
    • 1
  • Guoren Wang
    • 1
  • Zhiming Bai
    • 1
    Email author
  1. 1.Department of Urology, Affiliated Haikou Hospital, Xiangya School of MedicineCentral South UniversityHaikou CityChina

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