Bianca B Mengerink1, Sanne A L Van Leijsen2, Mark E Vierhout2, Joanna Inthout3, Ben W J Mol4, Alfredo L Milani5, Jan-Paul W R Roovers6, Hugo W F Van Eijndhoven7, Carl H Van Der Vaart8, Iris Van Gestel9, Francis E Hartog10, John F A Heesakkers2, Kirsten B Kluivers2. 1. Department of Obstetrics and Gynecology, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Obstetrics and Gynecology, Rijnstate Hospital, Arnhem, The Netherlands. Electronic address: Bianca.Mengerink@radboudumc.nl. 2. Department of Obstetrics and Gynecology, Radboud University Medical Center, Nijmegen, The Netherlands. 3. Radboud Institute for Health Sciences, Department for Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands. 4. The Robinson Institute, School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide, Australia. 5. Department of Obstetrics and Gynecology, Reinier de Graaf Group, Delft, The Netherlands. 6. Department of Obstetrics and Gynecology, Academic Medical Center Amsterdam, Amsterdam, The Netherlands. 7. Department of Obstetrics and Gynecology, Isala Klinieken, Zwolle, The Netherlands. 8. Department of Obstetrics and Gynecology, University Medical Center Utrecht, Utrecht, The Netherlands. 9. Department of Obstetrics and Gynecology, VieCuri, Venlo, The Netherlands. 10. Department of Obstetrics and Gynecology, Rijnstate Hospital, Arnhem, The Netherlands.
Abstract
INTRODUCTION: Stress urinary incontinence has a negative impact on sexual function. AIM: To assess the effect of midurethral sling surgery on sexual activity and function in women with stress urinary incontinence. METHODS: This is a secondary analysis of the Value of Urodynamics Prior to Stress Incontinence Surgery (VUSIS-II) study, which assessed the value of urodynamics in women with (predominantly) stress urinary incontinence. Patients who underwent retropubic or transobturator sling surgery were included in the present study if information was available on sexual activity before and 12 months after surgery. Data were collected from a self-report validated questionnaire combined with non-validated questions. The association between midurethral sling surgery and sexual function (coital incontinence, satisfaction, and dyspareunia) was compared with McNemar χ(2) tests for nominal data and paired t-tests for ordinal data. Potentially influential factors were analyzed with univariable and multivariable logistic regression analyses. MAIN OUTCOME MEASURES: Changes in sexual activity and sexual function after midurethral sling surgery. RESULTS: Information on sexual activity was available in 293 of the 578 women (51%) included in the VUSIS-II study. At baseline, 252 of 293 patients (86%) were sexually active vs 244 of 293 (83%) after 12 months. More patients with cured stress urinary incontinence were sexually active postoperatively (213 of 247 [86%] vs 31 of 46 [67%], P < .01). There was a significant decrease in coital incontinence (120 of 236 [51%] preoperatively vs 16 of 236 [7%] postoperatively, P < .01). De novo dyspareunia was present in 21 of 238 women (9%). There was a greater improvement in coital incontinence after placement of the retropubic sling compared with the transobturator sling (odds ratio = 2.04, 95% CI = 1.10-3.80, P = .02). CONCLUSION: These data show that midurethral sling surgery has an overall positive influence on sexual function in women with stress urinary incontinence. The retropubic sling is more effective than the transobturator sling for improvement of coital incontinence. De novo dyspareunia was present in 1 of 11 women.
INTRODUCTION:Stress urinary incontinence has a negative impact on sexual function. AIM: To assess the effect of midurethral sling surgery on sexual activity and function in women with stress urinary incontinence. METHODS: This is a secondary analysis of the Value of Urodynamics Prior to Stress Incontinence Surgery (VUSIS-II) study, which assessed the value of urodynamics in women with (predominantly) stress urinary incontinence. Patients who underwent retropubic or transobturator sling surgery were included in the present study if information was available on sexual activity before and 12 months after surgery. Data were collected from a self-report validated questionnaire combined with non-validated questions. The association between midurethral sling surgery and sexual function (coital incontinence, satisfaction, and dyspareunia) was compared with McNemar χ(2) tests for nominal data and paired t-tests for ordinal data. Potentially influential factors were analyzed with univariable and multivariable logistic regression analyses. MAIN OUTCOME MEASURES: Changes in sexual activity and sexual function after midurethral sling surgery. RESULTS: Information on sexual activity was available in 293 of the 578 women (51%) included in the VUSIS-II study. At baseline, 252 of 293 patients (86%) were sexually active vs 244 of 293 (83%) after 12 months. More patients with cured stress urinary incontinence were sexually active postoperatively (213 of 247 [86%] vs 31 of 46 [67%], P < .01). There was a significant decrease in coital incontinence (120 of 236 [51%] preoperatively vs 16 of 236 [7%] postoperatively, P < .01). De novo dyspareunia was present in 21 of 238 women (9%). There was a greater improvement in coital incontinence after placement of the retropubic sling compared with the transobturator sling (odds ratio = 2.04, 95% CI = 1.10-3.80, P = .02). CONCLUSION: These data show that midurethral sling surgery has an overall positive influence on sexual function in women with stress urinary incontinence. The retropubic sling is more effective than the transobturator sling for improvement of coital incontinence. De novo dyspareunia was present in 1 of 11 women.
Keywords:
Incontinence Surgery; Midurethral Sling; Midurethral Sling Surgery; Retropubic Sling; Sexual Activity; Sexual Function; Sexuality; Stress Urinary Incontinence; Transobturator Sling; Value of Urodynamics Prior to Stress Incontinence Surgery (VUSIS) I and II