11: The effect of anti-incontinence surgery on female sexual function: a combined secondary analysis of the stress incontinence surgical treatment efficacy trial and trial of mid-urethral slings

Abstract

To determine the impact of surgery for stress urinary incontinence (SUI) on 24-month postoperative condition-specific sexual function. This is a combined secondary analysis of the Trial of Mid-Urethral Slings (TOMUS) and the Stress Incontinence Surgical Treatment Efficacy Trial (SISTEr). SISTEr subjects (Burch colposuspension or Autologous fascial sling) and TOMUS subjects (retropubic or transobturator mid-urethral sling) who completed 24-month postoperative sexual function questionnaire (PISQ-12) were included. PISQ-12 scores were used to compare sexual function between groups at baseline, at 24 months postoperatively and the change in score. Descriptive statistics compared sexual function between the treatment groups and a multivariable model was fit to the data to control for significant baseline differences between treatment groups. Repeated measures ANOVA was used to identify time and treatment effects on sexual function. A total of 852 participants were included. Baseline differences between treatment groups include race/ethnicity, number of pregnancies and vaginal deliveries, stage of prolapse, and concomitant surgeries (Table 1). On univariate analysis, there was no significant difference between baseline, 24-month and change in sexual function between treatment groups (Table 2). Surgical treatment group was not associated with 24-month sexual function on multivariate analysis after adjusting for differences between groups, however objective failure rate was an independent predictor of postoperative sexual function. There is a significant improvement in sexual function over the 2 years following anti-incontinence surgery, but there is no treatment effect attributed to surgery type on repeated measures ANOVA (Figure 1). Women who are sexually active and undergoing surgical treatment for stress urinary incontinence have improved sexual function at 24 months postoperatively with no differences attributed to type of anti-incontinence surgery.View Large Image Figure ViewerDownload Hi-res image Download (PPT)View Large Image Figure ViewerDownload Hi-res image Download (PPT)