Tension Free Vaginal Tape for Repair of Stress Urinary Incontinence Affects Vaginal Elasticity and Sexual Function

Abstract

Objectives: Midurethral sling Placement for stress urinary incontinence (SUI) repair has a profound effect on both anatomical and physiologic properties of the anterior vaginal wall. The current study compared vaginal elasticity, mobility, and strength, using vaginal tactile imaging (VTI) changes before and after midurethral sling placement for treating SUI. Materials and Methods: This prospective cohort study included women undergoing midurethral sling placement to treat their SUI. Vaginal elasticity, levator ani muscle tone, and contraction strength were measured prior to treatment and 6 months following surgery, using VTI measurements. In addition, participants were asked to fill Female Sexual Function and Urinary Distress–6 questionnaires, among others, for sexual-function assessment. Results: A total of 23 women, with proven SUI, participated in the study. Their mean age was 51.2 ± 10.6 years and mean body mass index was 28.3 ± 5.5 kg/m2. There was a parallel, statistically significant increase in vaginal elasticity from 1.02 ± 0.47 to 1.44 ± 1.05 (p < 0.05), and FSFI scores from 21.49 ± 1.86 to 29.5 ± 1.16 (p < 0.0001). Furthermore, statistically significant increases in vaginal muscle tone and contraction strength developed from 2.97 ± 1.66 to 3.45 ± 1.47 (p < 0.05) and from 0.98 ± 0.6 to 1.36 ± 0.67 (p < 0.05), respectively. The increase in elasticity was moderately correlated with muscle-contraction strength (σ: 0.625; p < 0.0001) and vaginal tone in the anterior vaginal walls (σ: 0.702; p < 0.0001). Conclusions: SUI repair with midurethral-sling placement appears to increase vaginal elasticity, muscle tone, and contraction strength, and improves sexual function and urinary distress symptoms significantly. (J GYNECOL SURG 38:226)