The effect of tension-free vaginal tape on coital incontinence concomitant with stress urinary incontinence.

Abstract

The aim of this study was to evaluate the impact of tension-free vaginal tape (TVT) on coital incontinence concomitant with stress urinary incontinence. TVT was performed on sexually active women diagnosed with urodynamic stress incontinence (USI) who also experienced coital incontinence with penetration and/or orgasm. The patient-reported success rate was assessed by the Patient's Global Impression of Improvement (PGI-I) scale. The sexual function of the women was evaluated by the fulfilled Female Sexual Function Index (FSFI) before and after the operations. Eighty-two women underwent the TVT procedure with epidural anesthesia and 80 of them (97%) answered pre-operative and post-operative FSFI questionnaires. In the pre-operative clinical assessment, 48 women (58%) stated they experienced urinary incontinence during penetration, 13 (15%) during orgasm, and 21 (25%) identified it for both. The patient-reported success rate was 86% (71 of 82 patients) according to the PGI-I results: 44 of 48 women (91%) during penetration, nine of 13 (69%) during orgasm, and 18 of 21 (85%) for both. The FSFI scores for sexual desire, lubrication, and sexual arousal domains increased in 57 (71%), 49 (61%), and 44 (55%) patients, respectively, whereas they remained unchanged in 23 (28%), 31 (38%), and 36 (45%) patients. For the orgasm, satisfaction, and pain domains, the results were similar. The mean total FSFI score before the operations was 23.63 ± 6.84 and it significantly increased after surgery to 29.47 ± 4.28 (P < .05). The TVT procedure may offer treatment for coital incontinence accompanying USI. It also provides significant improvement in the sexual lives of women.