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Sexual Function After Prolapse Repair and Retropubic Versus Single-incision Sling.

Jennie E Choi¹, Robert E Gutman¹, Cheryl B Iglesia¹

¹MedStar Washington Hospital Center/Georgetown University, Washington, DC.

Urogynecology (Philadelphia, Pa.)

|June 4, 2026

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Sexual function improved for patients receiving either single-incision or retropubic slings for stress urinary incontinence. Both surgical methods demonstrated similar positive outcomes in sexual function, offering comparable results for women undergoing pelvic repair surgery.

Area of Science:

Urogynecology
Female Pelvic Medicine and Reconstructive Surgery

Background:

Surgical correction for stress urinary incontinence (SUI) and pelvic organ prolapse (POP) often improves sexual function.
Existing data show comparable sexual function outcomes between transobturator and retropubic slings for SUI.
Conflicting evidence exists regarding sexual function outcomes with newer single-incision slings.

Purpose of the Study:

To evaluate and compare sexual function after the placement of single-incision slings versus retropubic slings.
To assess these outcomes in patients undergoing concomitant native tissue vaginal repair for SUI.

Main Methods:

Secondary analysis of a multicenter, prospective randomized trial.
Included patients with stage ≥2 POP and confirmed SUI undergoing native tissue vaginal repair.

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Randomization to single-incision sling with sham incisions or retropubic sling, with sexual function assessed using the PISQ-IR questionnaire at baseline and 12 months.

Main Results:

Sexual function improved significantly from baseline in both single-incision (3.3 to 3.7, P<0.01) and retropubic sling groups (3.2 to 3.8, P<0.01).
No statistically significant difference in sexual function improvement was observed between the single-incision and retropubic sling groups (P=0.21).
Out of 227 participants, 72 reported continued sexual activity at 12 months.

Conclusions:

For sexually active women undergoing native tissue vaginal repair and concurrent sling placement for SUI, both single-incision and retropubic slings lead to improved sexual function.
The choice between single-incision and retropubic slings does not appear to impact sexual function outcomes in this patient population.