(PM-40) Interdisciplinary approach in a case of mixed urinary incontinence and dyspareunia: a case report

Abstract Objective Mixed urinary incontinence (MUI) negatively affects quality of life and sexual function. This study highlights the benefits of using an interdisciplinary approach to improve urogynecological symptoms and sexual function. Materials and Methods This clinical case report involves outpatient follow-up at a Women’s Health and Sexuality Clinic. Data was collected using medical records, the Hospital Anxiety and Depression Scale (HADS), the Female Sexual Function Index (FSFI), and the International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF). Results A 42-year-old female patient with two vaginal births presented complaints of dyspareunia, decreased vaginal lubrication, and MUI for the past two years. Initial assessment showed a HADS score of 25, indicating high anxiety and/or depression levels, an FSFI score of 11, suggesting severe sexual dysfunction, and an ICIQ-SF score of 16, demonstrating severe urinary incontinence. Physical examination revealed pelvic floor hypertonicity, particularly in the levator ani muscle, contractures in pelvic and hip muscles, and low self-perception of the pelvic floor with accessory musculature required during contraction. Weekly pelvic floor physiotherapy was initiated, combined with behavioral therapy, awareness and relaxation exercises for body, breathing, and genital areas, along with manual therapy, progressive vaginal dilation, and kinesis therapy. After 15 appointments, scores improved to HADS 9, FSFI 22, and ICIQ-SF 2, reflecting significant improvements in anxiety and depression symptoms, sexual function, and MUI, respectively. Discharge physical exam showed a normotonic pelvic floor, no contractures, globally reduced muscle tension, and improved body awareness. Conclusion An individualized, multidisciplinary approach for genitourinary syndrome effectively addresses physical, emotional, and sexual domains, leading to notable improvements in QoL. Financing No conflict.