Sexuality and is usually associated with frequency and nocturia

     Sexuality is an important and integral
part of every woman’s life, and in fact female sexual dysfunction can lead to
personal distress and anxiety. Under the term “female sexual dysfunction” is
included a variety of disorders associated with components of sexual function
such as sexual desire, arousal and orgasm and pain related to sexual
intercourse as well (Castagna
& Montorsi and Salonia 2015)  

     Despite the importance of a healthy sex
life to most people, research suggests that sexual dysfunction is common. Female
sexual dysfunction (FSD) can occur at any stage of life, may be lifelong or
acquired; situation-specific or generalized; and mild, moderate, or severe
based on the degree of distress it causes to the woman. The etiology is
multifactorial( Kingsberg, et al, 2017).

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     In general, factors that can contribute to
its development may be psychogenic, physical and mixed. Each of these factors consists
of individual components that influence the sexual response; however their
precise impact in FSD development and progression is unknown (Holly
N T, et al, 2016 ). Moreover, the role
of Overactive bladder syndrome to the development and progression of FSD has
been poorly investigated. Overactive bladder (OAB) is defined as frequent
urination with or without urge incontinence and is usually associated with
frequency and nocturia in the absence of an infection or other pathological
conditions. It is a common and distressing medical condition that can
severely affect patient’s quality of life (Gardikou
, et al, 2013).

     Overactive bladder (OAB) is a major cause
of suffering in many patients, requiring long-term therapy to maintain symptoms
relief. Incontinence or even the fear of leaking urine interferes with sexual
function. However, studies evaluating the burden of OAB on female sexual
function are limited. The aim of this study was to assess the prevalence of
sexual dysfunction among women with OAB(Milsom

    The prevalence of OAB
varies among populations, as the number of women who seek help and report the
symptoms depends on the social acceptance of incontinence. As a result of
ignorance, embarrassment and sometimes believing that incontinence is somewhat
‘normal’ due to birth and ageing, many women suffer for years before seeking
medical treatment. OAB generally accounts for 11%–19% of overall incidence
of incontinence worldwide. However, a study in the United States found
that the incidence of OAB was high: 48.3% in women . Studies in Asia also
quoted almost similar prevalence of OAB, though only one out of five patients
would usually seek treatment due to reasons mentioned earlier (Amidu N, et al, 2016)

OAB occurs when the bladder squeezes (contracts) suddenly without you having
control and when the bladder is not full. OAB syndrome is a common condition
where no cause can be found for the repeated and uncontrolled bladder
contractions. (For example, it is not due to a urine infection or an enlarged
prostate gland.) OAB syndrome is sometimes called an irritable bladder or
detrusor instability (detrusor is the medical name for the bladder muscle)( Herschorn,et

    The symptoms of OAB are
primarily due to the involuntary contractions of the detrusor muscle during the
filling phase of the micturition cycle. It is also termed detrusor overactivity
and is mediated by acetylcholine-induced stimulation of bladder muscarinic
receptors( Bargiota, et al, 2011).

     There are many risk
factors associated with OAB, such as obesity, history of pelvic organ prolapse,
multiparity, advanced age and menopause. Other conditions that can
stimulate involuntary contractions of bladder muscles must also be considered,
such as neurological conditions, medication use, urinary infection,
abnormalities in the bladder, etc (Chen C, et al, 2016).

     According to a large-scale internet survey
(EpiLUTS study), OAB affects mental health, work productivity , and sexual
health . OAB is also associated with urinary tract infection, falls, and
Maeda, et al, 2017).

     The principle management of OAB includes
conservative, medical and surgical options. Studies have shown that
conservative management that includes behavioural modification (bladder
training, avoidance of bladder irritants and management of fluid intake) with
pelvic floor exercise plays significant roles in managing OAB (Luria, et al,
2013). Medical therapy is helpful in patients who are
resistant to conservative management. The anti-cholinergic drug is a
well-accepted pharmacological treatment for OAB, but the side effects have
resulted in low compliance as proven by a study conducted in the United States,
where 81.8% of women discontinued drug treatment after less than 6 months,
partly due to the side effects of anti-cholinergic therapy. Other
modalities like sacral neuromodulation, tibial nerve stimulation or
intermittent botulinum toxin injection into the detrusor muscles are also
practised in patients with refractory OAB. Surgical intervention is
usually reserved as the last option, as the morbidities are more likely to cause
unfavourable consequences(Buster 2013)

      Nurses are often the initial health care
professionals who can detect, assess, and treat OAB. Nurses may screen for
problematic OAB by asking if the severity of symptoms. Health care providers
and policymakers may want to consider including OAB  in community based screening activities.
Results of this study support the need to design and implement an intervention
aimed at improving Egyptian women’s sexual functionrelated to OAB (Kang,
Phillips, and Sun, 2010).

     Nursing care intervention on sexuality has
improved symptoms of sexual dysfunction. Dyspareunia among the patients was
improved by 81.5%. Sexual intercourse, vaginal lubrication, sexual arousal,
sexual desire, and orgasm were also improved after the intervention. Education
and counseling as well as physical exercise may have contributed to reduce
dyspareunia and vaginal lubrication. Similarly, previous studies reported that
educational intervention could improve sexual and physical symptoms)  Chow, et al,2016).

     Education and counseling on sexuality are
nursing interventions used to assist patients to resolve their sexual problems.
In nurse-led counseling, a nurse provides information and assists patients in
making and executing a decision; the nurse also guides the survivor to regain
self-confidence and adapt to physical and psychological changes to optimize
survivor autonomy. Nurse-led psychosexual counseling can significantly improve
sexual function in women with OAB improve marital relationship(Shearer,M
& R,Shearer2017)