A Rahman, R Bugeja, K McCrossan, S Jha
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.
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.