Dr. Cornella, a physician at Mayo Clinic in Phoenix, Arizona, explains if a woman needs to see a doctor after involuntarily urinating during sexual intercourse and describes the aspects of sexual function that can improve with vaginal prolapse surgery.
If a patient experiences urinary loss during intercourse she should definitely consider seeing a physician. Most patients in that setting would either have loss due to the tube being weakened that drains the bladder, so it’s almost a mechanical effect of urinary leakage, or they may have a bladder contraction that they cannot control and then lose urine from bladder overactivity.
Each of those ways of losing urine may be improved by seeing a physician, undergoing testing and then the physician prescribing modalities of treatment that can make each of those better.
Women may often ask how prolapse surgery will affect sexual function. Actually prolapse has some deleterious effects on sexual function, in terms of resulting in pressure at the opening of the vagina from the prolapse, tendency towards urgency. If a patient has concomitant urinary incontinence they may experience urinary leakage during coitus.
Thus, actually there are aspects of sexual function, which can improve with surgery; this was shown in a very well done study by Rebecca Rogers at the University of New Mexico, in conjunction with Dr. Dorothy Kammerer-Doak. They showed improvements in aspects of sexual function following vaginal prolapse surgery.
When we approach the prolapse surgically, we are addressing the vagina. It does not affect the area of the clitoris or the nerves that go from the clitoris to the higher centers of the brain.