Sexual function following surgery for urodynamic stress incontinence |
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Authors: | Swati Jha Paul Moran Helen Greenham Caroline Ford |
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Institution: | (1) Urogynaecology Department, Birmingham Women’s Hospital, Metchley Park Road, Birmingham, B15 2TG, UK;(2) Department of Obstetrics and Gynaecology, Worcester Royal Hospital, Worcester Acute Hospitals NHS Trust, Charles Hastings Way, Worcester, WR 5 1DD, UK;(3) Present address: 123 Lodge Hill Road, Selly Oak, Birmingham, B29 6NL, UK |
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Abstract: | The objective of this study was to compare sexual function in women before and after surgery for urodynamic stress incontinence
in the absence of pelvic organ prolapse. This was a prospective questionnaire survey. Fifty-four women undergoing surgery
(tension-free vaginal tape/tension-free vaginal tape-obturator) for urodynamic stress incontinence with no evidence of detrusor
overactivity or concomitant prolapse were assessed preoperatively and 6 months post operatively. Assessment was based on the
Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ), the International Consultation on Incontinence Questionnaire
(ICIQ) and the Patient Global Impression of Improvement. Paired t-tests were used for comparing pre- and post-op scores and unpaired t-tests for comparing observations between groups. Spearman’s rank correlation was used for testing whether two numerically
scored items were related, and McNemar test was used to compare pre- and postoperative responses to individual questions.
ICIQ scores showed significant improvement after surgery (p < 0.001). Women completing PISQ were significantly younger (mean = 54) than those who did not (mean = 65; p < 0.001). The total PISQ score was better postoperatively (preoperative = 87.2, postoperative = 92.7; p < 0.001), with improvements in both the physical (preoperative = 31.0, postoperative = 35.2; p < 0.001) and partner-related domains (preoperative = 18.8, postoperative = 19.9; p = 0.002) but no improvement in behaviour emotive domains (preoperative = 37.3, postoperative = 37.6; p = 0.70). There was a reduction in episodes of coital incontinence postoperatively (preoperatively = 16/54, postoperatively = 39/54;
p < 0.002). Previous vaginal surgery, oestrogen status of respondents and hysterectomy status did not affect the PISQ. Surgical
correction of stress incontinence is associated with an improvement in sexual function. |
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Keywords: | Sexual function Incontinence Coital incontinence TVT TVT-O |
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