Sexual activity and function in women more than 2 years after midurethral sling placement

Zyczynski, Halina M.; Rickey, Leslie; Dyer, Keisha Y.; Wilson, Timothy H.; Stoddard, Anne M.; Gormley, E. Ann; Hsu, Yvonne; Kusek, John W.; Brubaker, Linda

doi:10.1016/j.ajog.2012.06.053

Cited by 41 publications

(25 citation statements)

References 16 publications

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“…We observed a significant improvement in all domains of the pelvic floor-specific questionnaire. Regarding dyspareunia after the implantation of suburethral slings for stress incontinence, there is inconsistent data [13,14]. In line with this, the risk of dyspareunia is present in any pelvic floor surgery, but special concern is raised in mesh-augmented POP repair [15].…”

Section: Discussionmentioning

confidence: 99%

Improvement of pelvic floor-related quality of life and sexual function after vaginal mesh implantation for cystocele: primary endpoint of a prospective multicentre trial

Farthmann

Mengel²,

Henne

et al. 2016

Arch Gynecol Obstet

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Section: Discussionmentioning

confidence: 99%

Improvement of pelvic floor-related quality of life and sexual function after vaginal mesh implantation for cystocele: primary endpoint of a prospective multicentre trial

Farthmann

Mengel²,

Henne

et al. 2016

Arch Gynecol Obstet

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“…Both the patients and their partners need to be considered here. The reports in the literature on sexual function after (mesh-based) surgery of the pelvic floor are inconsistent [15,32,33], and further research into dyspareunia after different surgical procedures is urgently required.…”

Section: Discussionmentioning

confidence: 99%

Quality of Life, Sexuality, Anatomical Results and Side-effects of Implantation of an Alloplastic Mesh for Cystocele Correction at Follow-up after 36 Months

Fünfgeld¹,

Stehle²,

Henne

et al. 2017

Geburtshilfe Frauenheilkd

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ABSTR AC TIntroduction Pelvic organ prolapse can significantly reduce quality of life of affected women, with many cases requiring corrective surgery. The rate of recurrence is relatively high after conventional prolapse surgery. In recent years, alloplastic meshes have increasingly been implanted to stabilize the pelvic floor, which has led to considerable improvement of anatomical results. But the potential for mesh-induced risks has led to a controversial discussion on the use of surgical meshes in urogynecology. The impact of cystocele correction and implantation of an alloplastic mesh on patientsʼ quality of life/sexuality and the long-term stability of this approach were investigated. MethodIn a large prospective multicenter study, 289 patients with symptomatic cystocele underwent surgery with implantation of a titanized polypropylene mesh (TiLOOP ® Total 6, pfm medical ag) and followed up for 36 months. Both primary procedures and procedures for recurrence were included in the study. Anatomical outcomes were quantified using the POP-Q system. Quality of life including sexuality were assessed using the German version of the validated P-QoL questionnaire. All adverse events were assessed by an independent clinical event committee.Results Mean patient age was 67 ± 8 years. Quality of life improved significantly over the course of the study in all investigated areas, including sexuality and personal relationships (p < 0.001, Wilcoxon test). The number of adverse events which occurred in the period between 12 and 36 months after surgery was low, with just 22 events reported. The recurrence rate for the anterior compartment was 4.5 %. Previous or concomitant hysterectomy increased the risk of recurrence in the posterior compartment 2.8-fold and increased the risk of erosion 2.25-fold.Conclusion Cystocele correction using a 2nd generation alloplastic mesh achieved good anatomical and functional results in cases requiring stabilization of the pelvic floor and in patients with recurrence. The rate of recurrence was low, the patientsʼ quality of life improved significantly, and the risks were acceptable. . The most serious effect of pelvic organ prolapse is impairment of bladder and bowel function accompanied by incontinence and voiding disorders [2,3]. General well-being, personal relationships, particularly sexuality [4], and physical and social activities often suffer from the effects of prolapse [5,6]. The incidence of pelvic organ prolapse in women has increased in parallel with the general increase in life expectancy, and the likelihood that women aged 80 years will require surgical intervention (e.g. hysterectomy, pelvic floor reconstruction) is 12.2 % [7]. One in nine women is affected by prolapse [8]. Up to 30 % of patients require a repeat operation for recurrence within 5 years of the original procedure [9][10][11][12]. Surgical correction of prolapse should not just reposition the prolapsed pelvic organs, it should also restore the patientʼs quality of life or at least improve it. As the recurrence rate...

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“…However, the available literature seems to suggest improvements in sexual function for the sexually active patients treated with MUS for SUI [50][51].…”

Section: Discussionmentioning

confidence: 99%

Updated Systematic Review and Meta-analysis of the Comparative Data on Colposuspensions, Pubovaginal Slings, and Midurethral Tapes in the Surgical Treatment of Female Stress Urinary Incontinence

et al. 2017

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CONTEXT: Retropubic (RT-TVT) and transobturator miurethral (TO-TVT) mid-urethral sling (MUS) are popular surgical treatments for female stress urinary incontinence (SUI). The long-term efficacy and safety of the procedures is still a topic of intense clinical research and several randomized controlled trials (RCTs) have been published in the last years OBJECTIVE: To evaluate the efficacy and safety of MUS compared with other surgical treatments for female SUI. EVIDENCE ACQUISITION:A systematic review and meta-analysis of the literature was performed using the Medline, Scopus, and Web of Science databases to update our previously published analyses. EVIDENCE SYNTHESIS:Twenty-eight RCTs were identified. In total, the meta-analyses CONCLUSIONS:The present analysis confirms the superiority of MUS over BC. The studies comparing insertion of RT-TVT and TO-TVT showed higher subjective and objective cure rates for the RP-TVT but at the cost of higher risks of some complications and voiding LUTS. Efficacy of 3 inside-out and outside-in techniques of TO-TVT insertion was similar, although the risk of vaginal perforation was lower in the inside-to-out TO-TVT. PATIENT SUMMARY:Retropubic and transobturator midurethral slings are a popular treatment for female stress urinary incontinence. The available literature suggest that those slings are either more effective or safer than other older surgical procedures. Retropubic tapes are followed with slightly higher continence rates as compared with the transobturator tapes but are associated with higher risk of intra-and postoperative complications. TAKE-HOME MESSAGESThe present analysis confirms the superiority of MUS over Burch colposuspension. The studies comparing insertion of RT-TVT and TO-TVT showed higher subjective and objective cure rates for the RP-TVT but at the cost of higher risks of some complications and voiding LUTS. Efficacy of inside-out and outside-in techniques of TO-TVT insertion was similar, although the risk of vaginal perforation was lower in the inside-to-out TO-TVT 4

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Sexual activity and function in women more than 2 years after midurethral sling placement

Cited by 41 publications

References 16 publications

Improvement of pelvic floor-related quality of life and sexual function after vaginal mesh implantation for cystocele: primary endpoint of a prospective multicentre trial

Improvement of pelvic floor-related quality of life and sexual function after vaginal mesh implantation for cystocele: primary endpoint of a prospective multicentre trial

Quality of Life, Sexuality, Anatomical Results and Side-effects of Implantation of an Alloplastic Mesh for Cystocele Correction at Follow-up after 36 Months

Updated Systematic Review and Meta-analysis of the Comparative Data on Colposuspensions, Pubovaginal Slings, and Midurethral Tapes in the Surgical Treatment of Female Stress Urinary Incontinence

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