Limits on vaginal intercourse after mid-urethral sling: a randomized trial.

Area of Science:

• Urogynecology
• Female Sexual Health
• Surgical Recovery

Background:

• Current recommendations advise 4-6 weeks of abstinence from intercourse after synthetic mid-urethral sling surgery for stress urinary incontinence.
• This recommendation lacks prospective study data to support its duration.

Purpose of the Study:

• To compare patient satisfaction between women resuming intercourse at 2 weeks (early) versus 6 weeks (standard) post-retropubic sling surgery.
• To evaluate differences in sexual function, urinary incontinence symptoms, and adverse events between the two groups.

Main Methods:

• A randomized, multicentered clinical trial involving sexually active women undergoing retropubic sling surgery.
• Women were randomized at 2 weeks post-surgery to either early (2 weeks) or standard (6 weeks) restriction from vaginal intercourse.
• Patient satisfaction, sexual function (including de novo dyspareunia), and urinary incontinence symptoms were assessed at 3 months post-surgery.

Main Results:

• Patient satisfaction with returning to vaginal intercourse was similar between the early (66%) and standard (68%) groups (P>.99).
• Women in the early resumption group significantly preferred the 2-week restriction (P=.0019).
• No mesh exposure occurred, and urinary incontinence and sexual function symptoms improved similarly in both groups by 3 months.

Conclusions:

• Resuming vaginal intercourse at 2 weeks versus 6 weeks after retropubic sling surgery yields comparable patient satisfaction and does not negatively impact efficacy or sexual function.
• Further research is needed to explore the effects of early return to sexual activity on de novo dyspareunia.
• A 2-week restriction is preferred by women undergoing retropubic sling surgery.