[Study of sexual function in women after surgery for stress urinary incontinence]

To investigate the change of the patients' sexual function after the surgeries for stress urinary incontinence (SUI).

Pelvic organ prolapse-urinary incontinence sexual function questionnaire (PISQ) was sent to 62 sexually active patients who underwent laparoscopic Burch colposuspension or had a tension free vaginal tape (TVT) inserted at least 6 months after the operation, to a maximum of 3 years. The patient was divided into two groups according to different operations, different follow-up intervals and whether there was concomitant coital incontinence before the operations respectively. The changes of PISQ scores before and after the operation were compared between two groups. For the groups not having significant difference in PISQ score, we compared the rate of PISQ score improvement and the rate of satisfaction postoperatively. Multivariate logistic regression analyses were performed to determine whether age, parity, body mass index, menstrual status, surgical history, medical illness, severity of SUI, concomitant hysterectomy and intraoperative or postoperative complications affected the change of sexual function.

Fifty-six patients answered the questionnaire giving a follow-up rate of 90%. The average score of PISQ was 85.2 +/- 10.7 and 82.4 +/- 17.7 before and after the surgery, and there was no significant difference (P > 0.05); however behavioral emotional domain scores worsened (30.5 +/- 6.6 vs 26.8 +/- 10.7, P < 0.05). The PISQ scores of the patients who underwent the operation within a year declined significantly (86.0 +/- 10.7 vs 77.7 +/- 18.6, P < 0.05), especially in behavioral emotional domain (31.0 +/- 7.2 vs 23.7 +/- 11.3, P < 0.01); however after a year, there was no significant change (84.4 +/- 10.8 vs 86.5 +/- 16.1, P > 0.05) and even an improvement in the physical domain (34.5 +/- 5.6 vs 36.9 +/- 4.3, P < 0.05). Regarding the sexual function improvement ratio, the patients who had the TVT operations (54% vs 12%) or had concomitant coital incontinence before the operations (62% vs 23%) were better (P < 0.01). The change of PISQ scores was independent of clinical features.

The operations of SUI have an adverse effect on the patients' sexual life within a year, which may recover after that period. TVT operation has a better effect on the patients sexual function compared with laparoscopic Burch colposuspension; the patients who have concomitant coital incontinence before the operations have a better sexual function improvement.