TY - JOUR
T1 - The Impact of Midurethral Sling Surgery on Sexual Activity and Function in Women With Stress Urinary Incontinence
AU - Mengerink, Bianca B.
AU - Van Leijsen, Sanne A.L.
AU - Vierhout, Mark E.
AU - Inthout, Joanna
AU - Mol, Ben W.J.
AU - Milani, Alfredo L.
AU - Roovers, Jan Paul W.R.
AU - Van Eijndhoven, Hugo W.F.
AU - Van Der Vaart, Carl H.
AU - Van Gestel, Iris
AU - Hartog, Francis E.
AU - Heesakkers, John F.A.
AU - Kluivers, Kirsten B.
PY - 2016/10
Y1 - 2016/10
N2 - Introduction Stress urinary incontinence has a negative impact on sexual function. Aim To assess the effect of midurethral sling surgery on sexual activity and function in women with stress urinary incontinence. Methods This is a secondary analysis of the Value of Urodynamics Prior to Stress Incontinence Surgery (VUSIS-II) study, which assessed the value of urodynamics in women with (predominantly) stress urinary incontinence. Patients who underwent retropubic or transobturator sling surgery were included in the present study if information was available on sexual activity before and 12 months after surgery. Data were collected from a self-report validated questionnaire combined with non-validated questions. The association between midurethral sling surgery and sexual function (coital incontinence, satisfaction, and dyspareunia) was compared with McNemar χ2 tests for nominal data and paired t-tests for ordinal data. Potentially influential factors were analyzed with univariable and multivariable logistic regression analyses. Main Outcome Measures Changes in sexual activity and sexual function after midurethral sling surgery. Results Information on sexual activity was available in 293 of the 578 women (51%) included in the VUSIS-II study. At baseline, 252 of 293 patients (86%) were sexually active vs 244 of 293 (83%) after 12 months. More patients with cured stress urinary incontinence were sexually active postoperatively (213 of 247 [86%] vs 31 of 46 [67%], P < .01). There was a significant decrease in coital incontinence (120 of 236 [51%] preoperatively vs 16 of 236 [7%] postoperatively, P < .01). De novo dyspareunia was present in 21 of 238 women (9%). There was a greater improvement in coital incontinence after placement of the retropubic sling compared with the transobturator sling (odds ratio = 2.04, 95% CI = 1.10–3.80, P = .02). Conclusion These data show that midurethral sling surgery has an overall positive influence on sexual function in women with stress urinary incontinence. The retropubic sling is more effective than the transobturator sling for improvement of coital incontinence. De novo dyspareunia was present in 1 of 11 women.
AB - Introduction Stress urinary incontinence has a negative impact on sexual function. Aim To assess the effect of midurethral sling surgery on sexual activity and function in women with stress urinary incontinence. Methods This is a secondary analysis of the Value of Urodynamics Prior to Stress Incontinence Surgery (VUSIS-II) study, which assessed the value of urodynamics in women with (predominantly) stress urinary incontinence. Patients who underwent retropubic or transobturator sling surgery were included in the present study if information was available on sexual activity before and 12 months after surgery. Data were collected from a self-report validated questionnaire combined with non-validated questions. The association between midurethral sling surgery and sexual function (coital incontinence, satisfaction, and dyspareunia) was compared with McNemar χ2 tests for nominal data and paired t-tests for ordinal data. Potentially influential factors were analyzed with univariable and multivariable logistic regression analyses. Main Outcome Measures Changes in sexual activity and sexual function after midurethral sling surgery. Results Information on sexual activity was available in 293 of the 578 women (51%) included in the VUSIS-II study. At baseline, 252 of 293 patients (86%) were sexually active vs 244 of 293 (83%) after 12 months. More patients with cured stress urinary incontinence were sexually active postoperatively (213 of 247 [86%] vs 31 of 46 [67%], P < .01). There was a significant decrease in coital incontinence (120 of 236 [51%] preoperatively vs 16 of 236 [7%] postoperatively, P < .01). De novo dyspareunia was present in 21 of 238 women (9%). There was a greater improvement in coital incontinence after placement of the retropubic sling compared with the transobturator sling (odds ratio = 2.04, 95% CI = 1.10–3.80, P = .02). Conclusion These data show that midurethral sling surgery has an overall positive influence on sexual function in women with stress urinary incontinence. The retropubic sling is more effective than the transobturator sling for improvement of coital incontinence. De novo dyspareunia was present in 1 of 11 women.
KW - Incontinence Surgery
KW - Midurethral Sling
KW - Midurethral Sling Surgery
KW - Retropubic Sling
KW - Sexual Activity
KW - Sexual Function
KW - Sexuality
KW - Stress Urinary Incontinence
KW - Transobturator Sling
KW - Value of Urodynamics Prior to Stress Incontinence Surgery (VUSIS) I and II
UR - http://www.scopus.com/inward/record.url?scp=84991039900&partnerID=8YFLogxK
U2 - 10.1016/j.jsxm.2016.08.005
DO - 10.1016/j.jsxm.2016.08.005
M3 - Article
C2 - 27641921
AN - SCOPUS:84991039900
SN - 1743-6095
VL - 13
SP - 1498
EP - 1507
JO - Journal of Sexual Medicine
JF - Journal of Sexual Medicine
IS - 10
ER -