Bladder dysfunction in sexual abuse survivors

Purpose: We determined the incidence of genitourinary dysfunction and urinary incontinence in self-identified sexual abuse survivors. Materials and Methods: In a preliminary study an incontinence and genitourinary symptom questionnaire was distributed to female members of sexual abuse survivor support groups and a control group of patients attending a general gynecology clinic. The 52 item questionnaire contained questions regarding general physical and psychological health, incontinence and voiding dysfunction symptoms, and sexual abuse history. Fischer's exact test was used to compare responses between groups. Results: Questionnaires from 58 sexual abuse survivors and 51 controls were included in the statistical analysis. Mean age +/- SD was higher in the control than in the abuse survivor group (47.8 +/- 18.5 vs 9.1 +/- 41.5 years, p = 0.03) but there was no difference in parity between groups (1.65 +/- 1.85 vs 1.36 +/- 1.44, p = 0.37). Of abuse survivors 72% and of controls 22% reported ever experiencing urinary incontinence symptoms (p < 0.001). Many symptoms of stress incontinence, urge incontinence and voiding dysfunction were also reported by a greater percent of abuse survivors than controls. Conclusions: Sexual abuse survivors have a significantly higher incidence of genitourinary dysfunction symptoms, including stress and urge incontinence, and voluntary urinary retention. Abuse survivors should be questioned about these symptoms, and evaluation and therapy should be recommended. This preliminary study demonstrates that the impact of psychological counseling in addition to medical therapy for urinary dysfunction in this group of patients deserves further study.