Psychosomatic aspects of urinary incontinence

Psychosomatic aspects of urogynecological disorders may play an important r ole in their clinical presentation. 72 patients presenting to the urogyneco logical clinics and a control group of 34 healthy women were included in th is study. After informed consent had been obtained, all patients were subje cted to (1) a detailed enquiry about personal- and medical history (2) psyc hological tests (Freiburg's personality inventory, a questionaire focused o n anxiety and anger, and Beck's depression inventory) and (3) routine urody namic measurement. Patients with stress incontinence had a mean duration of symptoms of 59 months. In 67% there was a combination with clinical urge s ymptoms. 53% of the patients did not have regular sexual intercourse. Of th ose who had regular intercourse 23% had incontinence during intercourse and 25% were anorgasmic. 59% of the patients had dysmenorrhea and a negative a ttitude to their menarche. Urodynamic evaluation showed stress, urge or no incontinence in 39%, 12% and 39%, respectively. Analysis of the psychosomat ic tests did not show a specific psychosomatic influence. Negative sexual l ife correlated with depressive mood, which was not based on the urogynecolo gical problem. There was no causal relationship between personality traits and urogynecological problems. The individual perception of incontinence, h owever, may depend on or influence personality structure.