Female Sexual Function Evaluation of the Tension-Free Vaginal Tape (TVT) and Transobturator Suburethral Tape (TOT) Incontinence Surgery: Results of a Prospective Study

Abstract

Introduction Significantly more women reporting stress urinary incontinence (SUI) or low urinary tract symptoms complained of sexual dysfunction than a general healthy female population. The use of a tension-free vaginal tape (TVT), placed transvaginally under the mid-urethra, ensures to reacquire continence but could affect sexual function. Aim This study aimed to determine if a suburethral tape for the correction of SUI could interfere with sexual activity. Methods Of 108 patients, 37 underwent positioning of a tension free vaginal tape through a retropubic approach (TVT), and 71 through a transobturator approach from outside to inside (TOT). Main Outcome Measures All patients enrolled had a complete urodynamic study and were invited to answer the Female Sexual Function Index questionnaire and our personal questionnaire, before surgery, after 1 month, and then at 3-month intervals. Results Of the 108 patients, 67% of the women experienced incontinence during intercourse, 96% during penetration, and 4% on orgasm. The cure rate for SUI was 97.1%. Sixty-two women (87%) with TOT placement and 31 (84%) with TVT were satisfied with the operation as regards sexual function, 68 (96%) and 29 (78%), respectively, with TOT and TVT had an improvement of urinary symptoms with resolution of urinary leakage during intercourse, after a 12.3-month follow-up. Just one patient treated with a TOT approach and two with the TVT complained of low grade of leakage. Of the 101 sexually active women, 90.1% reported a significant improvement in their sexual life, 9.9% referred a poor sexual activity not due to surgical intervention. Conclusions In the surgical treatment of SUI, it is important to think about the patients' future sexual life and inform them that the great part of women can expect to improve their quality of life.

Effects of Transobturator Midurethral Sling Surgery on Sexual Functions: One-Year Follow-Up

“…There was significant improvement in sexual functions in FSFI total scores and all domains. Pace and Vicentini [22], in a similar study in 71 women showed 90.1% improvement in the FSFI scores at the postoperative 12 months in 71 women after TOT. Bekker et al [23] suggested that there was 21.3% improvement in sexual functions after urinary incontinence surgery.…”

The effects of stress incontinence surgery on sexual function and life quality of women

“…Thereafter, many studies were performed in which validated questionnaires were used during preoperative and postoperative periods and sexually active women were included. In these studies, sexual functions were reported as improved, unchanged or worsened after SUI surgery (11)(12)(13)(14). The aim of this study is to evaluate the effects of Transobturator tape (TOT) and Burch colposuspension procedures performed for urodynamic stress urinary incontinence on the quality of life and sexual functions of women.…”

Sexual function and health-related quality of life following anterior vaginal wall surgery for stress urinary incontinence and pelvic organ prolapse

“…These results are in agreement with others. 11,25,27,28 Twenty-two patients (10 in the SUI group and 12 in the POP group) who were sexually active preoperatively did not regain sexual intercourse, because they worried that sexual activity would affect the surgical outcome. This is considered to be another negative effect on FSF after anterior vaginal surgery.…”

“…Recently, a number of studies have investigated the potential impact of surgical procedures for SUI and POP on women's sexual health. Several authors have documented improvements, [11][12][13] as well as declines in FSF, 2,14 whereas other authors have suggested that such procedures have no impact. 15,16 The primary objective of the present study is to compare FSF and HRQOL, before and after anterior vaginal wall surgery for SUI and POP.…”