LAUSR

PURPOSE: The purpose of this study was to examine effects of urinary incontinence (UI) on midlife women's relationships with their intimate partners, from the perspective of both women and their partners. DESIGN: A cross-sectional, mixed-methods design. SUBJECTS AND SETTING: Purposive, convenience/snowball sampling strategies and community-based recruitment strategies were used to enroll partnered, midlife women living with UI. Participants were 43 community-dwelling midlife couples residing in the southwestern United States; female participants had stress, urgency, or mixed UI by self-report. Data were also collected from their intimate partners. METHODS: Participants completed confidential mailed study packets comprising questionnaires on demographic information and lower urinary tract symptom profile, valid measures of the quality of the relationship, and open-ended questions to explore the effect of UI on the relationship in the participants' own words. The packet included several validated instruments: the Incontinence Severity Index, Couples Satisfaction Index, Sexual Quality of Life-Female/Male, Relational Ethics Scale, and Couples' Illness Communication Scale. Quantitative data were analyzed using tests of differences between groups and correlation analysis. Qualitative data were explored for themes and tested for significant differences in word choice by z-score analysis. RESULTS: We found no significant differences between women and their partners in measures of the relationship and no significant associations between UI symptom severity and relationship satisfaction. Distressed partners had significantly poorer scores on sexual quality of life (P < .001), relational ethics (P = .002), and communication about UI (P = .03). Distressed couples used significantly more words than did nondistressed couples who described the woman's withdrawal from shared activities (P = .005) and avoidance of physical intimacy (P = .003), which they attributed to UI. CONCLUSIONS: Distressed couples demonstrated the negative effects of UI on emotional and physical intimacy. Distress was attributed to how the woman coped with symptoms but not with the severity of UI symptoms.