Abstract
Stress urinary incontinence (SUI) negatively influences sexual functions. However, the available data on sexual activity of patients who underwent midurethral sling (MUS) implantation are inconsistent. Our aim was to evaluate the impact of MUS implantation on sexual functions of women with SUI. We enrolled 171 patients undergoing the MUS procedure. Preoperative examination included the cough test, 1 h pad test and the Prolapse/Urinary Incontinence Sexual Questionnaire, IUGA Revised (PISQ-IR). All patients had the retropubic sling implanted. Follow-up visits were performed 6–12 months after surgery. Objective cure rate was obtained in 90.98% of patients. Coital incontinence was reported by 56% of women before the surgery, and 8.6% afterwards. Among women who gained continence, significant improvement in sexual function was observed in the majority of the domains. In women who were not objectively cured (9.02%), we did not observe improvement in sexual life. All these patients indicated fear of leaking urine during sexual activity as the main cause of avoiding sex, similarly as before operation. To conclude, successful treatment of SUI with MUS significantly improves the quality of sexual life. On the other hand, persistent incontinence appears to be the most probable cause of lack of improvement in the quality of sexual life.
Highlights
Stress urinary incontinence (SUI) is a health issue that affects social, physical, psychological, domestic, occupational as well as sexual well-being [1]
It is estimated that female sexual dysfunction (FSD) may be experienced by more than 60% of women suffering from UI [4]
Sexual function was assessed with the Prolapse/Urinary Incontinence Sexual Questionnaire, IUGA Revised (PISQ-IR)—a condition-specific, validated and reliable instrument that evaluates sexual function in women with UI and/or pelvic organ prolapse (POP), and measures physical, behavioral-emotive and partner-related domains [14]
Summary
Stress urinary incontinence (SUI) is a health issue that affects social, physical, psychological, domestic, occupational as well as sexual well-being [1]. It appears to be influenced by organic and anatomic conditions, as well as psychological factors. Studies found that women with urinary incontinence (UI) report lower intercourse frequency, avoidance and even complete abstinence of sex [2]. Coital incontinence in women seeking therapy for UI was reported to range from 10% to 56% [3]. Accompanied by impaired body image, reduced self-esteem and avoidance of sex, those symptoms lead to female sexual dysfunction (FSD). A comparably high prevalence of sexual problems in women suffering from UI is reported by patients suffering from vulvovaginal atrophy associated with estrogen deficiency [5]
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