Sexual function after surgery for stress urinary incontinence: vaginal sling versus Burch colposuspension

We prospectively investigated the effect of surgery for stress urinary incontinence (SUI) on sexual function and also compared preoperative and postoperative sexual functions according to vaginal or abdominal surgery for SUI.

The study included 94 women who underwent surgery for SUI, and the women were divided into two groups: 53 women had vaginal sling, and 41 women had Burch colposuspension. Female sexual function was evaluated with a detailed 19-item questionnaire, the female sexual function index (FSFI), including sexual desire, arousal, lubrication, orgasm, satisfaction, and pain. In all women, sexual function was compared before and after surgery for SUI, and the differences in postoperative sexual functions were also compared between the women undergoing vaginal sling and Burch colposuspension.

In all women, total sexual function score significantly decreased from 20.8 +/- 9 to 17.3 +/- 9.3 after surgery (P = 0.000). Total sexual function score decreased from 19.2 +/- 10 to 17.2 +/- 9.9 in the vaginal sling group and decreased from 23.6 +/- 6.2 to 17.6 +/- 7.7 in the Burch colposuspension group, revealing significant difference between the two groups (P = 0.011). Statistically significantly higher decreases in postoperative sexual desire (P = 0.014), arousal (P = 0.026), lubrication (P = 0.004), and orgasm scores (P = 0.008) were also observed in the Burch colposuspension group than in the vaginal sling group. Based on total score, postoperative sexual function improved in 13 women (24.5%) of the vaginal sling group and in 5 women (12.2%) of the Burch colposuspension group, remained unchanged in 15 (28.3%) and 10 (24.4%), respectively, and deteriorated in 25 (47.2%) and 26 (63.4%), respectively.

Our findings show that sexual functions may be impaired after surgery for SUI. Burch colposuspension may deteriorate sexual functions much more than vaginal sling surgery in women. Therefore, women who will need surgery for SUI should be informed of the risk of deterioration of sexual function after surgery.