Sexual function after vaginal surgery for stress incontinence: results of a mailed questionnaire

To address the issue of sexual dysfunction after vaginal surgery for incontinence based on responses to a mailed questionnaire.

A sexual function questionnaire was mailed to 93 women who underwent anterior vaginal wall suspension for stress urinary incontinence alone (group 1) or in conjunction with a concomitant posterior repair (group 2) at least 1 year previously.

A total of 56 (60%) women responded. Following surgery, 10 (37%) women in group 1 reported themselves as sexually active and 12 (41%) in group 2, which was similar to preoperative values. Only 1 woman in group 1 and 3 women in group 2 attributed their sexual inactivity to their own lack of desire or inability to have intercourse. Overall, 20% of women noted pain during intercourse, a finding slightly lower than the preoperative incidence (29%). No difference in the incidence of dyspareunia was noted between groups. Still, several women (18%) reported intercourse to be worse following surgery. Women who were either premenopausal or on hormone replacement therapy were more likely to be sexually active following surgery (46%) than those not on hormone replacement (17%).

Overall, the percentage of women who were sexually active did not appear to be affected by a vaginal suspension procedure for incontinence. Symptomatic vaginal narrowing was rare, even among women undergoing simultaneous posterior repair. Still, nearly 20% of women considered intercourse to be worse postoperatively, although not all women reported dyspareunia. The possible causes for postoperative sexual dysfunction require further investigation.