Vaginal Mesh for Urinary Incontinence and Prolapse: Impact on Sexual Function

Abstract

The evolution of vaginal mesh has had a large positive impact on quality of life for patients with stress incontinence and pelvic organ prolapse; for instance, the mid-urethral sling is considered the gold standard treatment for stress incontinence. There are unique side effects, however, for the use of mesh in surgical implantation, including infection, erosion, extrusion, and changes in urinary habits as well. A side effect that may be overlooked in these women undergoing vaginal mesh surgery is sexual dysfunction; while the surgery itself may strongly improve quality of life, there can be some detrimental sexual side effects that may hinder the patient’s quality of life or sexual function overall. Changes in sexual function can be encountered in anywhere from 5 to 20% of all women undergoing surgery for stress incontinence or vaginal prolapse, and the scope of these changes vary from positive to negative. These changes can be broken down by sub-topics explored in the FSFI including dyspareunia or pain, overall function, lubrication, and orgasm. Sexual function is an often overlooked and underdiscussed topic in the medical field and between clinicians and patients overall. It is imperative that clinicians discuss any and all possible complications of mesh surgery with patients preoperatively, including any effects, both positive and negative, in regard to sexual function.