ORIGINAL ARTICLE Evaluation of coital incontinence by electronic questionnaire: prevalence, associations and outcomes in women attending a urogynaecology clinic Thomas Gray 1 & Weiguang Li 2 & Patrick Campbell 3 & Swati Jha 1 & Stephen Radley 1 Received: 19 January 2017 /Accepted: 13 May 2017 /Published online: 15 June 2017 # The International Urogynecological Association 2017 Abstract Introduction and hypothesis Coital incontinence is the invol- untary leakage of urine during sexual intercourse and is divid- ed into that occurring with penetration and that occurring with orgasm. Mechanisms of coital incontinence are poorly under- stood. The aim of this retrospective study was to measure the prevalence of coital incontinence and evaluate the association among various types of coital incontinence with stress urinary incontinence (SUI), overactive bladder (OAB) and impact on quality-of-life in women attending a urogynaecology clinic. Methods A total of 2,312 women completed the electronic Personal Assessment Questionnaire-Pelvic Floor (ePAQ-PF) in advance of their urogynaecology consultation. Logistic re- gression and Spearman’ s rank-order correlation evaluated asso- ciations between types of coital incontinence and OAB and SUI. The Mann–Whitney test evaluated the relationship between co- ital incontinence and self-reported quality of sex life and self- avoidance and partner avoidance of sex. Subgroup analysis analysed outcomes in 84 women with coital incontinence un- dergoing treatment with tension-free vaginal tape (TVT). Results Prevalence of coital incontinence in the cohort was 30%. Symptoms of OAB (p < 0.005) and SUI (p < 0.005) were significantly and independently associated with both types of coital incontinence (orgasm and penetration). In women with coital incontinence compared with those without, there was significant self-avoidance of sex (p < 0.0005), part- ner avoidance of sex (p < 0.0005) and impaired quality of sex life due to sexual problems (p < 0.005). The impact of this was significant in each group. Subgroup analysis of 84 women undergoing TVT showed significant improvement in all coital incontinence symptoms 3 months post-operatively. Conclusion Using an electronic questionnaire before consul- tation has identified coital incontinence to be a prevalent symptom, having a significant impact on the patient’ s sex life. Coital incontinence at orgasm and penetration are both signif- icantly associated with SUI and OAB. Keywords Coital incontinence . ePAQ-PF . Questionnaire . Computer interviewing . TVT . Orgasm Introduction Coital incontinence is a symptom occurring within the spec- trum of urinary incontinence in women and is defined as the complaint of involuntary loss of urine associated with coitus. This can be further divided into coital incontinence occurring with penetration and that occurring at orgasm [1]. Coital incontinence is prevalent in women attending urogynaecology clinics [2–4] and has been shown to affect up to 60% of women with urinary incontinence [5]. Coital incontinence has been shown to have a negative impact on quality of life [6]. The precise mechanism and aetiology of coital inconti- nence remains incompletely understood, with conflicting evi- dence presented in previous studies regarding the association between coital incontinence and stress urinary incontinence (SUI) and detrusor overactivity (DO). Previously, it has been observed in urodynamic studies that coital incontinence with orgasm was more strongly associated with overactive bladder * Thomas Gray Thomas.Gray@doctors.org.uk 1 Department of Urogynaecology, Sheffield Teaching Hospitals NHS Foundation Trust, c/o Tricia Kenyon, Level 4, Jessop Wing, Tree Root Walk, Sheffield S10 2SF, UK 2 University of Sheffield Medical School, Sheffield, UK 3 Belfast City Hospital, Belfast, UK Int Urogynecol J (2018) 29:969–978 DOI 10.1007/s00192-017-3380-x