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The Impact of Stress Urinary Incontinence Procedures (SUI) on Sexual Function: A Comparison between Tension-free
A Rahman1, R Bugeja2, K McCrossan1
1Department of Urogynaecology, Sheffield Teaching Hospitals NHS Foundation Trust, Jessop Wing, Tree Root Walk, Sheffield S10 2SF, UK.
Introduction:
Sexual dysfunction is common and affects around 50% of women with urinary incontinence. (1) Stress urinary incontinence (SUI) is associated with an increased prevalence of sexual dysfunction which can have a detrimental impact on patients' quality of life. (2) The aim of this study is to evaluate changes in sexual function following SUI surgery using paired pre-operative and post-operative patient-reported outcome assessments.
Materials And Methods:
This retrospective study included 100 women who had undergone surgery for SUI at a UK tertiary centre over a 10-year period. A database of validated questionnaires: Electronic Personal Assessment Questionnaire (ePAQ-PF), were used pre-operative and post-operatively. Four domains within the sexual function dimension were analysed: urinary, vaginal, dyspareunia and general sex life. Domain scores were calculated and statistical analysis completed using paired T-test to compare pre- and post-operative values. A one-way analysis of variance (ANOVA) test was used to compare results.
Results:
The mean age of patients in our study was 51 years. The level of sexual activity post-operatively did not change. All procedures showed an improvement in the impact of urinary symptoms on sexual activity (p < 0.05). Dyspareunia following both Tension-free Vaginal Tape (TVT) and Autologous fascial slings (AFS) demonstrated significant improvement in the post-operative period however the results were not statistically significant within the Burch Colposuspension (BC) group (p = 0.12). Analysis of the general sex life domain demonstrated that there was improvement following AFS (p = 0.006) and BC (p = 0.002), with non-significant improvement in the TVT cohort (p = 0.07). One-way ANOVA revealed statistically significant differences in the change in sex and bladder domain scores (p < 0.001) and sex and vagina domain scores (p = 0.002) between the surgical cohorts.
Conclusion:
Our findings show that sexual function improves after SUI surgery across multiple domains. The choice of surgery, however, may have a different impact on sexual function and therefore, patient quality of life. It is therefore important that women are adequately counselled regarding this. Further research is required to confirm these findings.
