Table 3 Effect of surgical treatments of stress urinary incontinence on sexual function
From: Impact of urinary incontinence on female sexual health in women during midlife
Study | Design | N | Treatment | Length of Follow Up (months) | Instrument | Findings | Coital Incontinence | |||
|---|---|---|---|---|---|---|---|---|---|---|
Overall Post-Operative Sexual Function | Improved | Worsened | No Difference | |||||||
Midurethral sling: Retropubic (TVT) | ||||||||||
Jha et al [62] | Prospective case series | 62 | TVT | 3 | ePAQ | N/A | • Impact of LUTS on sex (p < 0.001) | N/A | • Partner avoidance of sex (p = 0.06) | • Improved (p < 0.001) |
• Avoidance of sex (p < 0.001) | ||||||||||
• Anxiety of UI & sex (p < 0.001) | ||||||||||
Ghezzi et al [70] | Prospective case series | 53 | TVT | 6-12 | PISQ | • Improved: 34 % | N/A | N/A | • Fear of incontinence | • Improved in 87 %, with associated improvement: |
• Worsened: 3.8 % | • Frequency | • Frequency | ||||||||
• Fear of CI | ||||||||||
• Embarrassment | ||||||||||
Midurethral sling: Retropubic (TVT) versus Transobterator (TVT-O, TOT) comparative studies | ||||||||||
Elzevier et al [71] | Prospective cohort | 1. TVT-O: 34 | 1. TVT-O | 3-4 | Lemack | • Improved: 20.6 & 18.2 % (TVT, TVT-O respectively) | N/A | • Dyspareunia from vaginal narrowing in TOT [vs TVT-O] (p = 0.026) | • Frequency | • Improved |
2. TOT: 44 | 2. TOT | • Worsened: 5.9 & 18.2 % (TVT, TVT-O respectively |  | • Lubrication loss (p = 0.612) | ||||||
• Clitoral lumescence reduction, sensibility (p = 0.191, p = 0.346 respectively) | ||||||||||
Jha et al [64] | Prospective cohort | 1. TVT: 43 | 1. TVT | 6 | PISQ | N/A | • Total PISQ (p < 0.001) | N/A | • Behavior emotive subdomain (p = 0.7) | • Improved (p < 0.002) |
2. TVT-O: 11 | 2. TVT-O |  |  |  | • Partner, Physical subdomains (p = 0.002, p < 0.001 respectively) | |||||
Zyczynski et al [67] | RCT | 1. TVT: 298 | 1. TVT | 24 | PISQ | N/A | • Total PISQ (p < 0.0001) | • PISQ in surgical failure [vs success] (p = 0.009) | • PISQ between TVT & TOT | • Improved (p < 0.0001) |
2. TOT: 299 | 2. TOT | • Pain (p = 0.003) | • Proportion of sexually active patients post-op | |||||||
• Fear of UI & sex (p < 0.0001) | ||||||||||
Filocamo et al [61] | Prospective cohort | 1. TVT: 28 | 1. TVT | 12 | FSFI | N/A | • Total FSFI (p < 0.002) | N/A | • FSFI between TVT & TOT | N/A |
2. TOT: 105 | 2. TOT | • All subdomains (p < 0.002) | ||||||||
• Sexual dysfunction (P = 0.05) | ||||||||||
Cayan et al [75] | Prospective cohort | 1. TVT or vaginal repair: 53 | 1. TVT or vaginal repair | 1. Sling: 32.1 +/- 13.7 | FSFI | • Improved: 24.5 & 12.2 % (TVT, Burch respectively) | N/A | • Total FSFI (p < 0.001) | • Pain (p = 0.162) | N/A |
2. Burch: 41 | 2. Burch | 2. Burch: 35.7 +/- 16.7 | • Worsened: 47.2 & 63.4 % (TVT, Burch respectively) | • Desire, arousal, lubrication, orgasm, satisfaction subdomains (p ≤ 0.002) | ||||||
• Total FSFI, desire, arousal, lubrication, orgasm in Burch [vs TVT] (p = 0.004-0.026) | ||||||||||
Periurethral bulking injection | ||||||||||
Leone Roberti Maggiore et al [76] | Prospective case series | 29 | Polyacrylamide hydrogel periurethral injection | 12 | PISQ, Global sexual satisfaction VAS score | N/A | • Total PISQ (p < 0.001) | • Global sex satisfaction in surgical failure [vs success] (p < 0.001) | • Pain (p = 0.244) | • Improved (p < 0.001) |
• Desire, orgasm frequency, excitation, satisfaction, fear of UI & sex, negative emotional reaction, orgasm intensity (p < 0.001) | ||||||||||
• Global sex satisfaction VAS score (p < 0.001) | ||||||||||