Impact of conventional versus retropubic TOT procedures on female sexual function

Urinary incontinence, coital incontinence, dyspareunia, and sexual dysfunction are clinical conditions that can result from this condition. Treatment options include conservative and surgical approaches. The gold standard in surgery is mid-urethral sling procedures. The aim of this study is to compare the effects of the commonly used conventional transobturator tape (TOT) and retropubic transobturator tape (TOTRP) techniques on female sexual function and to evaluate possible differences, particularly regarding dyspareunia. A total of 108 sexually active women with stress urinary incontinence who underwent conventional TOT (n = 54) or TOTRP (n = 54) surgery between January 2023 and January 2025 were included in the study. Women aged 18-60 years who presented to the clinic for stress urinary incontinence between January 2023 and January 2025, were sexually active, underwent TOT or TOTRP surgery, and had a minimum of 6 months postoperatively were included in the study. The FSFI questionnaire data and demographic characteristics of patients in this group, as routinely collected in our practice, were retrieved from the hospital database and patient files. Data analysis and statistics were performed using jamovi software (version 2.6.44). No significant differences were found between the demographic and clinical characteristics of the two groups included in the study. A significant increase in postoperative FSFI scores was observed in both groups compared to the preoperative period. No significant difference was found between TOT and TOTRP in terms of total FSFI scores. However, when FSFI subscales were examined, a significant improvement in dyspareunia scores was observed only in the TOTRP group in the postoperative period (p < 0.001). No significant change in dyspareunia was observed in the conventional TOT group. Postoperative coital incontinence decreased significantly in both groups. Conventional TOT and TOTRP techniques provide a general improvement in female sexual function after SUI surgery. Although there is no significant superiority between the techniques in terms of total sexual function scores, improvement in dyspareunia scores was observed in the TOTRP group; however, direct superiority over conventional TOT could not be established. Prospective, randomized, long-term follow-up studies are needed to confirm these findings.