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Original Article Effects of Kegel Exercises Applied to Urinary Incontinence on Sexual Satisfaction

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Original Article Effects of Kegel Exercises Applied to Urinary Incontinence on Sexual Satisfaction Int J Clin Exp Med 2016;9(6):12365-12374 www.ijcem.com /ISSN:1940-5901/IJCEM0021587 Original Article Effects of kegel exercises applied to urinary ıncontinence on sexual satisfaction Şenay Topuz1*, Emine Ü Seviğ2* 1Department of Midwifery, Health Science Faculty, Ankara University, Ankara, Turkey; 2Department of Public Health Nursing, Health Science Faculty, Erciyes University, Kayseri, Turkey. *Equal contributors. Received December 10, 2015; Accepted March 19, 2016; Epub June 15, 2016; Published June 30, 2016 Abstract: This study is a semi-experimental study in order to explore the effect of Kegel exercises upon sexual sat- isfaction among the women who suffered from urinary incontinence. The sample of the study is consisted of 30 women who are diagnosed with urinary incontinence. Illustrative data form, GRISS were initially applied to women, kegel exercises were taught to women by the researcher and after 3 months of application were filled with scales. All of the women who were studied are at least primary school graduate and are married. Before the application it was seen that the women had problems in GRISS satisfaction, touch, vaginismus and anorgasmia sub groups. Yet, after the application its seen that the sexual satisfaction raised in these sub groups except vaginismus. A very important positive change was experienced in satisfaction and anorgasmia. A rise in sexual satisfaction was also detected after the application on thickness and avoidance sub groups and on total points. As a result of the study, it was detected that kegel exercises had positive effect on womens sexual satisfaction. However, performing of long term and broader sample studies shouldbe offered. Keywords: Urinary incontinence, kegel exercises, sexual satisfaction, nursing Introduction sis, insensible incontinence and coital inconti- nence. Stress urinary incontinence is the most Urinary incontinence common form (50-70%) [2-4]. In the last updated report of International Although UI prevalence increases with age and Continence Society (ICS); urinary incontinence includes all age groups; UI affects women more. (UI) is a medical and social disorder that is Generally; it is stated in the literature that uri- defined as any involuntary leakage of urine, nary incontinence prevalence among women causes many psychological problems-from varies between 4.8% and 58.4% but the exact embarrassment to depression- despite not ratio is unknown [5, 6]. In a study done in being a life-threatening condition and therefore Mexico, it is reported that incontinence preva- results in reduced self-confidence, social isola- lence ranges between 26.2% and 35% [7] and tion and deteriorated quality of life. In addition; in another study done in Saudi Arabia found daily domestic activities, professional activities incontinence prevalence as 29% [8]. The results and sexual lives of individuals who suffer from of the study of Özerdoğan et al. [9] conducted incontinence problem are affected negatively, with 625 women aged ≥20 years pointed out too [1, 2]. that urinary incontinence prevalence is 26%. Again; some relevant studies found urinary Forms, prevalence and ıncidence of urinary incontinence prevalence as 27% [10], 33.7% incontinence [11] and 45.3% [12]. Some of the incontinence forms defined by ICS Risk factors for urinary incontinence are stress incontinence, reflex/urge inconti- nence, mixed incontinence, functional inconti- One of the most important risk factors for uri- nence, postural incontinence, nocturnal enure- nary incontinence is gender. The fact that Effects of kegel exercises on sexual satisfaction women have such anatomic differences as without incontinence problem had more sexual short urethra and physiological events such as intercourses than those with incontinence pregnancy and birth occur in women’s body problem (91%-50%) and women with inconti- causes that UI is seen twice and three times nence problem emphasized that their sexual more among women as compared with men. desire decreased due to incontinence, most of However; pelvic floor muscles weaken with age them were embarrassed owing to incontinence thus leading to reduced gender differences [5, and their body image reduced. According to the 13-15]. Other risk factors which are related to results of the study of Beji et al. [23]; it was indi- pregnancy and birth are number of pregnan- cated that sexual lives of 43.7% of the women cies, births, type of delivery, birth complica- was affected by UI problem, used different tions, assisted delivery, amount of weight gain methods in case that their partners could during pregnancy and birth weight of neonates notice UI problem and tried to delay sexual [14, 16]. Other possible risk factors are over- intercourse. The study of Aslan et al. [24], too, weight, cigarette smoking and alcohol use, con- detected that there was an evident decrease in stipation, menopause and hysterectomy [15, the scores of Female Sexual Function Index of 17, 18]. women with UI. Giuseppe et al. [25] stated that among the women who suffered from UI and Treatment inurinary incontinence were treated with transvaginal electrical stimu- lation; 37 women who had incontinence com- Conservative approaches still remain the most plaints and 23 women who had sexual dysfunc- important methods for the current treatment tion showed considerable improvements in modalities of urinary incontinence. In the clini- sexual lives and after the treatment. cal practice guideline of Agency for Health Care Policy and Research for individuals with urinary Urinary incontinence and nursing incontinence; it is recommended that the meth- od that is the least invasive and the least dan- As a result; it is a fact accepted by everybody gerous should be the first choice of treat- that urinary incontinence negatively affects ment for the patients. The most practiced one women’s lives from every aspect particularly among the conservative treatments is pelvic from sexual aspect. However; since people with floor muscle exercises. These exercises, also UI have difficulty expressing this problem, known as Kegel Exercises, are designed in either no treatment is provided for them or they order to strengthen pelvic floor muscles and are too late for the treatment. Untreated incon- thus to improve urethral sphincter function. tinence problem negatively affects women’s Kegel Exercises are done particularly for whole lives including their sexual lives and strengthening PFM in case of stress inconti- decreases their quality of life. Therefore; it will nence [2]. make significant contributions to the develop- ment of women’s health to prevent urinary Urinary incontinence and sexuality incontinence through preventive measures before it occurs and to provide appropriate Pelvic floor muscles play important roles in sex- medical interventions through early detection ual arousal, sexual response and sexual satis- methods. One of the most important health faction of women. Hypertonic or hypotonic care personnel to make these contributions is structure of these muscles may lead to prob- nurses. That most of the nurses are women lems during sexual intercourse or orgasm and and they are employed at every kind of institu- urinary incontinence [19, 20]. tions that provide health care services will facil- According to Önem et al.; UI and pelvic organ itate their access to women. For the prevention prolapsus are among the main risk factors that and treatment of UI; particularly; nurses who cause women sexual dysfunction. In the results were trained about UI and work at urogynecol- of the relevant studies; it was detected that uri- ogy units the number of which has recently nary system signs led to pain and sexual arous- been increasing day by day-play an critical roles al problems during sexual intercourse and in the multidisciplinary health care team thanks therefore affected sexual functions of women to their clinician, counselor, trainer, researcher, negatively [21]. supporter and coordinator roles and thus pro- vide crucial contributions in preventing and The result of the study of Coyne et al. [22] on UI solving UI problem which deteriorates women’s and sexual dysfunction reported that women quality of life [5, 26-28]. 12366 Int J Clin Exp Med 2016;9(6):12365-12374 Effects of kegel exercises on sexual satisfaction Materials method was developed by Rust and Golombok was done by Tuğrul et al. [31]. It is a 5 point Likert The current research was a semi-experimental type inventory and consists of 7 subscales study in order to explore the effect of Kegel and 28 questions. High scores indicate an exercises upon sexual satisfaction among the impaired quality in sexual functions and sexual women who suffered from urinary incontinence. relations. The population of the study consisted of the women who had urinary incontinence com- Data collection plaint and attended urogynecology polyclinic of Dr. Zekai Tahir Burak Women’s Health, Training After the participants who were diagnosed with and Research Hospital between the 1st of UI were thoroughly instructed in the aims and October and the 1st of December, 2009. details of the study and informed consents Formula of theratio obtained from two indepen- were obtained; they were included in the study. dent groups or sample size formula of two pro- After questionnaire forms and the inventory portions (significance test for difference of two were administered to the women; the research- proportions) were used in order to calculate er provided the women with explanations about sample size and to determine the number of the place of urogynecological organs, Kegel the subjects to be recruited for intervention exercises, how to do Kegel exercises, its bene- group and control group [29]. fits and important points when Kegel exercises were practiced through the training guide. In line with the data presented in the literature; Afterwards; inventory forms which contained it was found out that the improvement in the the name and phone number of the researcher group in which pelvic floor muscle exercises to be used when necessary and which were to were done was 85% while the improvement in be filled in three months later were distributed the control group was 52% [30].
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