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Female sexual function following mid-urethral slings for the treatment of stress urinary incontinence

International Journal of Impotence Research volume 28, pages 121–126 (2016)Cite this article

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Abstract

The aim of our study was to describe the impact of mid-urethral sling procedure for the treatment of stress urinary incontinence (SUI) on female sexual function. We used PubMed (updated March 2015) to conduct a literature electronic search that included peer-reviewed English language articles. We analyzed the studies about the impact of mid-urethral slings on female sexual function. There are different and contradictory results of the effects of mid-urethral sling on female sexual function. However, more papers show that women undergoing mid-urethral sling procedures report that their sexual function is improved or remains unchanged. The main mechanism of this improved sexuality is the complete relief from coital incontinence, reduction in anxiety and avoidance of sex, whereas the most common symptom related to worsened sexual activity is dyspareunia. Women undergoing sling procedures for SUI should be informed that their sexual activity is likely to remain unchanged or even improve after the operation, but that dyspareunia may occur.

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References

  1. Hunskaar SAE, Burgio K, Diokno AC, Herzog AR, Mallett VT . Epidemiology and natural history of urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct 2000; 11: 301–319.

    Article  CAS  PubMed  Google Scholar 

  2. Abrams PCL, Khoury S, Wein A (eds). Incontinence, 3rd international consultation on incontinence. Health Publications Ltd: Paris, France, 2005; 541–545.

    Google Scholar 

  3. Masters WH, Jhonson VE . Human Sexual Response. Little, Brown: St Louis, MO, USA, 1966.

    Google Scholar 

  4. Kaplan HS . The New Sex Therapy: Active Treatment of Sexual Disorders. Bailliere Tindall: London, UK, 1974.

    Google Scholar 

  5. Kingsberg SA, Rezaee RL . Hypoactive sexual desire in women. Menopause 2013; 20: 1284–1300.

    Article  PubMed  Google Scholar 

  6. Suh DD, Yang CC, Cao Y, Garland PA, Maravilla KR . Magnetic resonance imaging anatomy of the female genitalia in premenopausal and postmenopausal women. J Urol 2003; 170: 138.

    Article  PubMed  Google Scholar 

  7. Yilmaz U, Kromm BG, Yang CC . Evaluation of autonomic innervation of the clitoris and bulb. J Urol 2004; 172: 1930.

    Article  PubMed  Google Scholar 

  8. Yucel S, de Souza A Jr, Baskin LS . Neuroanatomy of the human female lower urogenital tract. J Urol 2004; 172: 191.

    Article  PubMed  Google Scholar 

  9. Weber AM, Walters MD, Schover LR, Mitchinson A . Vaginal anatomy and sexual function. Obstet Gynecol 1995; 86: 946.

    Article  CAS  PubMed  Google Scholar 

  10. Meyer-Bahlburg HFL, Dolezal C . The Female Sexual Function Index: a methodological critique and suggestions for improvement. J Sex Marital Ther 2007; 33: 217–224.

    Article  PubMed  Google Scholar 

  11. Jha SRS, Farkas A, Jones G . The impact of TVT on sexual function. Int Urogynecol J Pelvic Floor Dysfunct 2009; 20: 165–169.

    Article  PubMed  Google Scholar 

  12. Sutherst JR, Brown M . Sexual dysfunction associated with urinary incontinence. Urol Int 1980; 35: 414–416.

    Article  CAS  PubMed  Google Scholar 

  13. Hilton P . Urinary incontinence during sexual intercourse: a common, but rarely volunteered, symptom. Br J Obstet Gynaecol 1988; 95: 377–381.

    Article  CAS  PubMed  Google Scholar 

  14. Walters MD, Taylor S, Schoenfeld LS . Psychosexual study of women with detrusor instability. Obstet Gynecol 1990; 75: 22–26.

    CAS  PubMed  Google Scholar 

  15. Clark A, Romm J . Effect of urinary incontinence on sexual activity in women. J Reprod Med 1993; 38: 679–683.

    CAS  PubMed  Google Scholar 

  16. Field SM, Hilton P . The prevalence of sexual problems in women attending for urodynamic investigation. Int Urogynecol J Pelvic Floor Dysfunct 1993; 4: 212–215.

    Article  Google Scholar 

  17. Vierhout ME, Gianotten WL . Mechanisms of urine loss during sexual activity. Eur J Obstet Gynecol Reprod Biol 1993; 52: 45–47.

    Article  CAS  PubMed  Google Scholar 

  18. Berglund AL, Fugl-Meyer KS . Some sexological characteristics of stress incontinent women. Scand J Urol Nephrol 1996; 30: 207–212.

    Article  CAS  PubMed  Google Scholar 

  19. Lemack GE, Zimmern PE . Sexual function after vaginal surgery for stress incontinence: results of a mailed questionnaire. Urology 2000; 56: 223–227.

    Article  CAS  PubMed  Google Scholar 

  20. Barber MD, Visco AG, Wyman JF, Fantl JA, Bump RC . Continence Program for Women Research Group. Sexual function in women with urinary incontinence and pelvic organ prolapse. Obstet Gynecol 2002; 99: 281–289.

    PubMed  Google Scholar 

  21. Hannestad YS, Rortveit G, Sandik H, Hunskaar S . A community-based epidemiological survey of female urinary incontinence: the Norwegian Epincont study. Epidemiology of Incontinence in the County Nord-Trondelag. J Clin Epidemiol 2000; 53: 1150–1157.

    Article  CAS  PubMed  Google Scholar 

  22. Burgio KL, Matthews KA, Engel BT . Prevalence, incidence and correlates of urinary incontinence in healthy, middle-aged women. J Urol 1991; 146: 1255–1259.

    Article  CAS  PubMed  Google Scholar 

  23. Salonia A, Nappi RE, Briganti A, Dehò F, Fabbri F, Colombo R et al. Sexual dysfunction is common in women with lower urinary tract symptoms and urinary incontinence: results of a crosssectional study. Eur Urol 2004; 45: 642–648.

    Article  PubMed  Google Scholar 

  24. Shaw C . A systematic review of the literature on the prevalence of sexual impairment in women with urinary incontinence and the prevalence of urinary leakage during sexual activity. Eur Urol 2002; 42: 432–440.

    Article  PubMed  Google Scholar 

  25. Espu Pons M, Puig Clota M . Coital urinary incontinence: impact on quality of life as measured by the King’s Health Questionnaire. Int Urogynecol J Pelvic Floor Dysfunct 2008; 19: 621–625.

    Article  Google Scholar 

  26. Serati MSS, Uccella S, Cromi A, Khullar V, Cardozo L, Bolis P . Urinary incontinence at orgasm: relation to detrusor overactivity and treatment efficacy. Eur Urol 2008; 54: 911–917.

    Article  PubMed  Google Scholar 

  27. Serati M, Salvatore S, Uccella S, Nappi RE, Bolis P . Female urinary incontinence during intercourse: a review on an understudied problem for women’s sexuality. J Sex Med 2009; 6: 40–48.

    Article  PubMed  Google Scholar 

  28. Petros PEP, Ulmsten UI . An integral theory of female incontinence: experimental and clinical considerations. Acta Obstet Gynecol Scand 1990; 69 (153 suppl): 7–31.

    Article  Google Scholar 

  29. Ulmsten UHL, Johnson P, Varhos G . An ambulatory surgical procedure under local anesthesia for treatment of female urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct 1996; 7: 81–85.

    Article  CAS  PubMed  Google Scholar 

  30. JO DeLancey . Structural support of the urethra as it relates to stress urinary incontinence: the hammock hypothesis. AmJ Obstet Gynecol 1994; 170: 1713–1720.

    Article  Google Scholar 

  31. E Delorme . Transobturator urethral suspension: mini-invasive procedure in the treatment of stress urinary incontinence in women. Prog Urol 2001; 11: 1306–1313.

    Google Scholar 

  32. Novara GGA, Boscolo-Berto R, Secco S, Cavalleri S, Ficarra V, Artibani W . Complication rates of tension-free midurethral slings in the treatment of female stress urinary incontinence: a systematic review and meta-analysis of randomized controlled trials comparing tension-free midurethral tapes to other surgical procedures and different devices. Eur Urol 2008; 53: 288–308.

    Article  PubMed  Google Scholar 

  33. Nilsson CG PK, Rezapour M, Falconer C . Eleven years prospective follow-up of the tensionfree vaginal tape procedure for treatment of stress urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct 2008; 19: 1043–1047.

    Article  CAS  PubMed  Google Scholar 

  34. Hines TM . The G-Spot: a modern gynaecologic myth. Am J Obstet Gynecol 2001; 185: 359–362.

    Article  CAS  PubMed  Google Scholar 

  35. Maaita M, Bhaumik J, Davies AE . Sexual function after using tension-free vaginal tape for the surgical treatment of genuine stress incontinence. BJU Int 2002; 90: 540–543.

    Article  CAS  PubMed  Google Scholar 

  36. Yeni EUD, Verit A, Kafali H, Ciftci H, Gulum M . The effect of tension-free vaginal tape (TVT) procedure on sexual function in women with stress urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct 2003; 14: 390–394.

    Article  PubMed  Google Scholar 

  37. Mazouni CKG, Bretelle F, Bladou F, Gamerre M, Serment G . Urinary complications and sexual function after the tension-free vaginal tape procedure. Acta Obstet Gynecol Scand 2004; 83: 955–961.

    Article  PubMed  Google Scholar 

  38. Ghezzi FSM, Cromi A, Uccella S, Triacca P, Bolis P . Impact of tension-free vaginal tape on sexual function: results of a prospective study. Int Urogynecol J Pelvic Floor Dysfunct 2006; 17: 54–59.

    Article  PubMed  Google Scholar 

  39. Kuhn AEC, Burkhard F, Mueller MD . Correction of erosion after suburethral sling insertion for stress incontinence: results and related sexual function. Eur Urol 2009; 56: 371–376.

    Article  PubMed  Google Scholar 

  40. Glavind K, Larsen T, Lindquist ASI . Sexual function in women before and after tension-free vaginal tape operation for stress urinary incontinence. Acta Obstet Gynecol Scand 2014; 93: 986–990.

    Article  PubMed  Google Scholar 

  41. Jha SMP, Greenham H, Ford C . Sexual function following surgery for urodynamic stress incontinence. Int Urogynecol J Pelvic Floor Dysfunct 2007; 18: 845–850.

    Article  PubMed  Google Scholar 

  42. vRH Murphy M, Mercurio E, Haff R, Wiseman B, Lucente VR . Incontinence-related quality of life and sexual function following the tension-free vaginal tape versus the “inside-out” tension-free vaginal tape obturator. Int Urogynecol J Pelvic Floor Dysfunct 2008; 19: 481–487.

    Article  Google Scholar 

  43. Pace G, Vicentini C . Female sexual function evaluation of the tension-free vaginal tape (TVT) and transobturator suburethral tape (TOT) incontinence surgery: results of a prospective study. J Sex Med 2008; 5: 387–393.

    Article  PubMed  Google Scholar 

  44. Pace G, Vicentini C . Female sexual function after surgery for stress urinary incontinence: transobturator suburethral tape vs. tensionfree vaginal tape obturator. J Sex Med 2008; 5: 400–406.

    Article  Google Scholar 

  45. Filocamo MT, Serati M, Frumenzio E, Marzi VL, Cattoni E, Champagne A et al. The Impact of mid-urethral slings for the treatment of urodynamic stress incontinence on female sexual function: a multicenter prospective study. J Sex Med 2011; 8: 2002–2008.

    Article  PubMed  Google Scholar 

  46. De Souza A, Dwyer P, Rosamilia A, Hiscock R, Lim Y, Murray C et al. Sexual function following retropubic TVT and transobturator Monarc sling in women with intrinsic sphincter deficiency: a multicentre prospective study. Int Urogynecol J 2012; 23: 153–158.

    Article  PubMed  Google Scholar 

  47. Scheiner D, Betschart C, Wiederkehr S, Seifert B, Fink D, Perucchini D . Twelve months effect on voiding function of retropubic compared with outside-in and inside-out transobturator midurethral slings. Int Urogynecol J 2012; 23: 197–206.

    Article  PubMed  Google Scholar 

  48. Liang C-C, Tseng L-H, Lo T-S, Lin Y-H, Lin Y Jr, Chang S-D . Sexual function following outside-in transobturator midurethral sling procedures: a prospective study. Int Urogynecol J 2012; 23: 1693–1698.

    Article  PubMed  Google Scholar 

  49. Zyczynski HM, Rickey L, Dyer KY, Wilson T, Stoddard AM, Gormley EA et al. Sexual activity and function in women more than 2 years after midurethral sling placement. Am J Obstet Gynecol 2012; 207: 421.e1–e6.

    Article  Google Scholar 

  50. Dursun M, Otunctemur A, Ozbek E, Cakir SS, Polat EC . Impact of the transobturator tape procedure on sexual function in women with stress urinary incontinence. J Obstet Gynaecol Res 2013; 39: 831–835.

    Article  PubMed  Google Scholar 

  51. Abdel-Fattah M, Ford JA, Lim CP, Madhuvrata P . Single-incision mini-slings versus standard midurethral slings in surgical management of female stress urinary incontinence: a meta-analysis of effectiveness and complications. Eur Urol 2011; 60: 468–480.

    Article  PubMed  Google Scholar 

  52. Kennelly M, Moore R, Nguyen J, Lukban J, Siegel S . Miniarc single-incision sling for treatment of stress urinary incontinence: 2-year clinical outcomes. Int Urogynecol J 2012; 23: 1285–1291.

    Article  PubMed  Google Scholar 

  53. Sun M-J, Sun R, Li Y-I . A comparative study of a single-incision sling and a transobturator sling: clinical efficacy and urodynamic changes. Int Urogynecol J 2013; 24: 823–829.

    Article  PubMed  Google Scholar 

  54. Naumann G, Steetskamp J, Meyer M, Laterza R, Skala C, Albrich S et al. Sexual function and quality of life following retropubic TVT and single-incision sling in women with stress urinary incontinence: results of a prospective study. Arch Gynecol Obstet 2013; 287: 959–966.

    Article  PubMed  Google Scholar 

  55. Naumann G, Steetskamp J, Meyer M, Laterza R, Skala C, Albrich S et al. Changes in sexual function and quality of life after single-incision mid-urethral sling for treatment of female stress urinary incontinence. Eur J Obstet Gynecol Reprod Biol 2013; 168: 231–235.

    Article  PubMed  Google Scholar 

  56. Elzevier HW, Venema PL, Nijeholt AA . Sexual function after tension-free vaginal tape (TVT) for stress incontinence: results of a mailed questionnaire. Int Urogynecol J Pelvic Floor Dysfunct 2004; 15: 513–518.

    Google Scholar 

  57. Glavind K, Tetsche MS . Sexual function in women before and after suburethral sling operation for stress urinary incontinence: a retrospective questionnaire study. Acta Obstet Gynecol Scand 2004; 83: 965–968.

    Article  PubMed  Google Scholar 

  58. Marszalek M, Roehlich M, Racz U, Metzenbauer M, Ponholzer A, Rauchenwald M et al. Sexual function after tension-free vaginal tape procedure. Urol Int 2007; 78: 126–129.

    Article  PubMed  Google Scholar 

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Author notes

  1. A Alwaal and X Tian: These two authors contributed equally to this work.

Authors and Affiliations

  1. Department of Urology, King Abdulaziz University, Jeddah, Saudi Arabia

    A Alwaal

  2. Department of Urology, University of California School of Medicine, San Francisco, CA, USA

    A Alwaal, G Lin & D Deng

  3. Department of Urology, The Third Affiliated Hospital, Peking University, Beijing, China

    X Tian, Y Huang, L Zhao & L Ma

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  1. A Alwaal
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Correspondence to A Alwaal.

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Alwaal, A., Tian, X., Huang, Y. et al. Female sexual function following mid-urethral slings for the treatment of stress urinary incontinence. Int J Impot Res 28, 121–126 (2016). https://doi.org/10.1038/ijir.2016.16

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