Long-term Follow-up of Sexual Function in Women Before and After Tension-Free Vaginal Tape Operation for Stress Urinary Incontinence

A number of studies have investigated the effect of incontinence surgery on sexual function in women. Results have been conflicting; some studies have reported improvement, some deterioration, and others no difference. Most of these studies had a 6- to 12-month follow-up period; few investigated the long-term effect after more than 12 months, and none compared short and long-term effects. The aim of this prospective study was to determine the long-term effects on sexual function among women who underwent tension-free vaginal tape (TVT) surgery and compare short-and long-term outcomes. Between November 2008 and June 2010, 63 patients fulfilling inclusion criteria had a TVT operation performed at the Department of Gynecology and Obstetrics, Aalborg University Hospital. Prior to surgery, 6 months postoperatively, and at a mean 4 years 9 months, patients completed the Pelvic Organ Prolapse Urinary Incontinence Sexual Questionnaire 12 (PISQ-12) and the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF). The PISQ-12 evaluates sexual function in women with pelvic organ prolapse and/or incontinence (higher score is better), and the ICIQ-UI SF evaluates the severity of urinary incontinence and its impact on health-related quality of life (lower score is better). A total of 44 women completed the 2 questionnaires all 3 times. Prior to surgery, mean PISQ-12 was 33.8 (95% confidence interval [CI], 28.9-38.6) and at 6 months increased to 36.7 (95% CI, 31.5-41.9) and at long-term follow-up was 35.8 (95% CI, 33.6-38.1). Preoperatively, ICIQ-UI SF was 15.2 (95% CI, 14.4-16.0) and at 6 months' follow-up decreased to 2.5 (95% CI, 1.3-3.8) and at long-term follow-up was 4.9 (95% CI, 3.4-6.3). The greatest improvement was found in the physical domain of the PISQ-12. With respect to itemized scores for PISQ-12 questions after TVT surgery, women reported less negative emotional reactions during intercourse, less coital incontinence, and less fear of being incontinent during intercourse. These data show that sex life in women does not deteriorate after a TVT operation, that sexual function improves in some, and that results are maintained over time.