Female sexual function following surgery for stress urinary incontinence: tension-free vaginal versus transobturator tape procedure

The aim of this study was to compare sexual function outcome following tension-free vaginal (TVT) versus transobturator tape (TOT) for stress urinary incontinence (SUI). All women who underwent TVT or TOT procedures for SUI with no concomitant prolapse repair between January 2002 and July 2007 were sent a retrospective pre-post questionnaire. Eighty-one and 64 women were sexually active before and after TVT and TOT procedures, respectively. Sexual function outcome did not differ pre- and postoperatively for the TVT and TOT groups, and postoperatively between the two groups. Responders reported an improvement of intercourse satisfaction in 23 (29.5%) and 21 (32.9%) cases, whereas 14 (17.3%) and eight (12.5%) complained of sexual function deterioration after TVT and TOT procedure, respectively (p = 0.43). This study suggests that anti-incontinence surgery can have a positive and negative outcome on sexual function, with no significant differences between the TVT and TOT procedures.     

The impact of TVT on sexual function

The aim of this study was to evaluate sexual function in women before and after tension-free vaginal tape (TVT) procedure. In this questionnaire-based study, 100 women undergoing TVT for stress incontinence were assessed preoperatively and 3 months postoperatively using a validated pelvic floor symptoms assessment questionnaire. The incidence and impact of TVT on orgasm incontinence, penetration incontinence, anxiety related to bladder problems during sex, avoidance of intercourse, and overall impact on sex life were assessed. Incontinence during intercourse was reported in 68% of women preoperatively. Following TVT, there were significant reductions in orgasm incontinence, penetration incontinence, anxiety regarding the bladder and sex, avoidance of sex, post-coital infection, and overall impact of lower urinary tract symptoms on sex. There was a non-significant reduction in partner avoidance of sex. TVT significantly improves the overall sex lives of women with stress urinary incontinence. Orgasm incontinence, penetration incontinence, post-coital infections, anxiety, and avoidance of sex are all reduced. This study was conducted at the Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Trust, Glossop Road, Sheffield, S10 2SF, UK.     

Change of sexual function after midurethral sling procedure for stress urinary incontinence

Objectives:   To compare sexual function in women before and after the midurethral sling procedure for stress urinary incontinence (SUI).
Methods:   A total of 75 women undergoing surgery for SUI between September 2005 and September 2006 were recruited for this study. Those who completed the Female Sexual Function Index (FSFI) preoperatively and 6 months postoperatively were included in the analysis. The FSFI is a validated, 19-item questionnaire, which assesses six domains of sexual function, including desire, arousal, lubrication, orgasm, satisfaction, and pain.
Results:   Data were analyzed for 47 patients. Overall sexual function after the midurethral sling procedure was not significantly different. There were no significant differences in overall sexual function or any of the individual FSFI domain scores between patients with and without concomitant posterior colporrhaphy. There were no significant differences in sexual function between the transobturator and the retropubic surgical routes.
Conclusions:   There is no significant change in overall sexual function in women undergoing the midurethral sling procedure. Posterior colporrhaphy and operative methods do not affect overall sexual function.     

Sexual function after tension-free vaginal tape (TVT) for stress incontinence: results of a mailed questionnaire

In a retrospective study we evaluated sexual function after tension-free vaginal tape (TVT) placement for urinary stress incontinence based on responses to a mailed questionnaire at least 3 months after the operation, to a maximum of 1 year. From 1999 to 2002, a sexual function questionnaire was mailed to 128 women (and their partners) who had undergone a TVT procedure for genuine urinary stress incontinence, without pelvic organ prolapse or detrusor instability. The questionnaire was returned by 96 women (75%), 69 (72%) of whom reported being sexually active. Mean frequency of intercourse did not change. Overall, 26% described improved intercourse compared to before the operation. Only one patient described worsening of intercourse after the TVT operation because of an increase in her incontinence. Overall, in this study the technique of tension-free vaginal tape as such seems to have no negative impact on sexual function. However, because of its successful outcome on incontinence, it has a positive overall effect on sexual function. The possible causes of postoperative partner discomfort require further investigation.Abbreviations AVWS Anterior vaginal wall suspension - SUI Stress urinary incontinence - TVT Tension-free vaginal tape This study was supported by the Pelvic Floor & Sexuality research group Leiden. Editorial Comment: The impact of urogynecologic surgery on sexual function is unclear. For those who are incontinent with intercourse, cure of incontinence may improve sexual activity at the price of potential damage to the vaginal anatomy. In this study sexual function following the TVT procedure was evaluated. The authors report that sexual frequency was overall unchanged, and many patients felt that intercourse improved. It appears that much of this improvement is probably related to cure of the incontinence rather than any specific features of the TVT. Although the study is flawed by its retrospective design and a long interval between the procedure and the questionnaire, the results overall are reassuring.     

Impact of tension-free vaginal tape on sexual function: results of a prospective study

The purpose of this study was to prospectively assess the impact of a TVT insertion for the treatment of stress urinary incontinence (SUI) on coital incontinence and overall sexual life. Sexually active women with pure SUI and without concomitant pelvic organ prolapse scheduled for TVT procedure completed a sexual function questionnaire at baseline and 6 months after surgery. Fifty-three patients were enrolled. Preoperatively 23 (43.4%) women experienced urine leakage during intercourse, 21 (91%) during penetration and 2 (9%) on orgasm. The objective cure rate for SUI was 98%. Coital incontinence was cured in 20 of 23 patients (87%). Thirty-three (62.2%) women reported no change in sexual function after surgery and 18 (34%) reported an improvement. Of the latter, 17 (94%) were of those cured from coital incontinence. No significant difference in the incidence of dyspareunia was found postoperatively. Two patients (3.8%) reported intercourse to be worse following surgery, one because of a vaginal erosion and one cited de novo anorgasmia as the main reason.     

Sexual Function in Women Attending a Urogynecology Clinic

The study prospectively evaluated the relationship between sexual dysfunction and urodynamic diagnoses in 100 consecutive female patients referred for urogynecologic evaluation. Sexual function was evaluated by a detailed questionnaire that addressed four phases of the sexual cycle: desire, arousal, orgasm and satisfaction. Each phase of the sexual cycle was assessed separately using a score of 1–4. Total sexual function (TSF) score was calculated by combining the scores of the four examined parameters (range 4–16). Analysis revealed statistically significant (P<0.05) lower TSF scores in patients with detrusor instability (DI) than in those with genuine stress incontinence, sensory urge or mixed urodynamic diagnoses (8.65 ± 4 versus 12.22 ± 3.6, 10.25 ± 4.1 and 11.47 ± 4.1, respectively). Three per cent of the elderly women (>60 years) compared to 29% of the younger women (≤60 years) reported urinary incontinence during sexual activity. Sexual function should therefore be routinely evaluated in women presenting with urinary symptoms.     

Evaluation of coital incontinence by electronic questionnaire: prevalence,associations and outcomes in women attending a urogynaecology clinic

Introduction and hypothesis

Coital incontinence is the involuntary leakage of urine during sexual intercourse and is divided into that occurring with penetration and that occurring with orgasm. Mechanisms of coital incontinence are poorly understood. The aim of this retrospective study was to measure the prevalence of coital incontinence and evaluate the association among various types of coital incontinence with stress urinary incontinence (SUI), overactive bladder (OAB) and impact on quality-of-life in women attending a urogynaecology clinic.

Methods

A total of 2,312 women completed the electronic Personal Assessment Questionnaire-Pelvic Floor (ePAQ-PF) in advance of their urogynaecology consultation. Logistic regression and Spearman’s rank-order correlation evaluated associations between types of coital incontinence and OAB and SUI. The Mann–Whitney test evaluated the relationship between coital incontinence and self-reported quality of sex life and self-avoidance and partner avoidance of sex. Subgroup analysis analysed outcomes in 84 women with coital incontinence undergoing treatment with tension-free vaginal tape (TVT).

Results

Prevalence of coital incontinence in the cohort was 30%. Symptoms of OAB (p < 0.005) and SUI (p < 0.005) were significantly and independently associated with both types of coital incontinence (orgasm and penetration). In women with coital incontinence compared with those without, there was significant self-avoidance of sex (p < 0.0005), partner avoidance of sex (p < 0.0005) and impaired quality of sex life due to sexual problems (p < 0.005). The impact of this was significant in each group. Subgroup analysis of 84 women undergoing TVT showed significant improvement in all coital incontinence symptoms 3 months post-operatively.

Conclusion

Using an electronic questionnaire before consultation has identified coital incontinence to be a prevalent symptom, having a significant impact on the patient’s sex life. Coital incontinence at orgasm and penetration are both significantly associated with SUI and OAB.

     

Sexual function following outside-in transobturator midurethral sling procedures: a prospective study

Introduction and hypothesis

Midurethral tapes have shown favorable clinical outcomes for treating stress urinary incontinence (SUI), but the effects of outside-in transobturator midurethral sling procedures (TOT) on women??s sexual function are unclear. We hypothesized that TOT might improve sexual function in women with SUI and therefore conducted this study to investigate sexual function alteration among women who underwent TOT for urodynamic stress incontinence (USI).

Methods

From November 2009 to October 2010, we recruited 102 women scheduled for correction of USI by TOT procedures in a tertiary hospital. In addition to urogynecologic history, pelvic examination, and urodynamic testing, participants were required to complete three validated questionnaires: Incontinence Impact Questionnaire (IIQ-7), Urogenital Distress Inventory (UDI-6), and Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12). Preoperative and postoperative results of these validated questionnaires were evaluated.

Results

Eighty-three patients comprising 57 sexually active and 26 sexually inactive patients participated in the 12-month evaluation. Of the 83 patients undergoing TOT, six (7.2?%) had postoperative SUI 12?months postoperatively. Both UDI-6 and IIQ-7 scores were significantly improved postoperatively. The total PISQ-12 score did not change significantly after surgery. Postoperatively, the individual incontinence-related items of the PISQ-12 improved, but climax with intercourse and negative emotional reactions during intercourse worsened (both with p <0.001). There was a negative correlation between SUI-related items on UDI-6 and those on PISQ-12 preoperatively.

Conclusions

TOT procedures for correcting USI had favorable clinical outcomes and did not alter overall sexual function; however, climax during sexual intercourse and emotional response worsened postoperatively.     

Sexual function in women with urinary incontinence

To date limited data exists that addresses the impact of urinary incontinence on sexual function. In the present study, we assessed sexual functions in patients with urinary incontinence and compared with healthy continent subjects by means of Female Sexual Function Index (FSFI) questionnaire. A total of 21 premenopausal incontinent women (three stress incontinence, nine overactive bladder and nine mixed incontinence) were enrolled in the study, and 18 healthy continent subjects served as controls. All subjects were asked to complete FSFI questionnaire and each FSFI domain scores including desire, arousal, lubrication, orgasm, satisfaction and pain were calculated. The mean scores in each domain were compared between the groups. Mean age of subjects with urinary incontinence and controls were 39.5+/-6.6 and 32.6+/-9.1 y, respectively. All domain scores were significantly lower in incontinent women except for pain. Among the incontinence types, no significant difference was determined in all domains of FSFI. Urinary incontinence significantly reduces sexual functions in premenopausal sexually active women.     

Female urinary incontinence: patient-reported outcomes 1?year after midurethral sling operations

Introduction and hypothesis

Although midurethral slings have become standard surgical methods to treat stress urinary incontinence (SUI), little is known about women who still have urinary incontinence (UI) after surgery. This study assesses and compares the patient-reported outcome 12?months after tension-free vaginal tape (TVT), tension-free vaginal tape-obturator (TVT-O), and transobturator tape (TOT), with a special focus on women who still have urinary leakage postoperatively.

Methods

This study analyzed preoperative and 12-month postoperative data from 3,334 women registered in the Swedish National Quality Register for Gynecological Surgery.

Results

Among the women operated with TVT (n?=?2,059), TVT-O (n?=?797), and TOT (n?=?478), 67?%, 62?%, and 61?%, respectively, were very satisfied with the result at the 1-year follow-up. There was a significantly higher chance of becoming continent after TVT compared with TOT. In total, 977 women (29?%) still had some form of urinary leakage postoperatively. Among the postoperatively incontinent women who expressed a negative impact of UI on family, social, work, and sexual life preoperatively, considerably fewer reported a negative impact in all domains after surgery. Of those in the postoperatively incontinent group who had coital incontinence preoperatively, 63?% reported a cure of coital incontinence.

Conclusions

The proportion of women very satisfied with the result of the operation did not differ between the three groups. TVT had a higher SUI cure rate than did TOT. Despite urinary leakage 1-year postoperatively, half of the women were satisfied with the result of the operation.     

The effect of pelvic floor training on sexual function of treated patients

The aim of this study was to determine the effects of improvements in urinary incontinence resulting from pelvic floor rehabilitation on the sexual function of patients. The study involved 42 clinic patients who received pelvic floor rehabilitation treatment. Their sexual histories were obtained through face-to-face interviews. Pelvic muscle strength was measured with a perineometer. Improvement in incontinence was measured with the pad test. Seventeen women reported decreased sexual desire before the treatment; 5 of these indicated improvement after treatment. Nine of 17 women who experienced dyspareunia prior to treatment reported an improvement afterwards, and four women reported complete relief from pain. Five of 15 women who complained of difficulty in reaching climax before the treatment experienced improvement in this area. In conclusion, an improvement in sexual desire, performance during coitus and achievement of orgasm were observed in women who received pelvic floor muscle rehabilitation. No change was seen in the arousal and resolution stages of sexual activity.Abbreviation FES Functional electrical stimulationEditorial Comment: Previous studies suggest that the prevalence of sexual dysfunction is high amongst women with urinary incontinence. Some data exist about the effect of surgical treatment of urinary incontinence and its effect on sexual function. Data also exist that women with sexual dysfunction due to painful conditions improve with pelvic floor therapy. It could be expected that women with urinary incontinence and sexual dysfunction show better overall improvement of both conditions when treated with pelvic floor therapy rather than with surgery. Patients in this study showed improvement in urinary incontinence with pelvic floor therapy. They also had a marked decrease in dyspareunia. Overall, there was improvement in sexual function, particularly an increase in desire. Unfortunately, the study does not address whether this improvement appears to be related to a decrease in incontinence, a decrease in pain with intercourse or an additive effect.     

Sexual function after suburethral sling removal for dyspareunia

Introduction  Impact on sexual function has received little attention in the medical literature for a long time. Because of the site of insertion of permanent tension free vaginal tape (TVT) the G spot might be affected or the tape might interfere with arousal and sensory stimulation. Recent studies have reported varying degrees of sexual impairment after TVT insertion ranging from 0% to 15% including dyspareunia. Aim  The aim of this study was to evaluate sexual function before and after suburethral sling removal due to postoperative female de novo dyspareunia. As a secondary outcome, general patients’ satisfaction with their overall continence situation was assessed. Patients and methods  Between December 2005 and December 2007, we included 18 female patients who complained of de novo dyspareunia after suburethral sling insertion for urinary stress incontinence. All patients filled in an FSFI questionnaire prior to sling removal and at 3 months postoperatively. Additionally, all women were asked to estimate their general satisfaction regarding their continence situation using a Visual Analogue Scale (VAS) from 0 to 10, with 0 being the least satisfying situation and 10 being the most satisfying situation. All patients underwent gynaecological examination including ICS-pelvic organ prolapse staging (ICS-POP score). Results  Of the 18 slings, ten were transobturator tapes (6 × TVT-O, 2 × Monarch, 2 × unknown) and eight were retropubic tapes (7 × TVT, 1 × SPARC). Desire, arousal, lubrication, satisfaction, and pain improved statistically significant. Orgasm scores were low with median scoring of 1.5 scores before and 1.0 scores after sling removal, and they did not change significantly after sling removal. The satisfaction rate deteriorated from a median of 7 (95% confidence interval [CI] 6.3–7.7) to a median of 4 (95% CI 3.7–5.1; p = 0.99) but not statistically significant. Conclusions  Sexual function in patients with de novo dyspareuina is likely to improve after sling removal but not in all domains. Bladder function may deteriorate.     

Evaluation of sexual function in women with overactive bladder syndrome

INTRODUCTION: Of late, little data is available concerning factors affecting female sexual function. In the present study, we evaluated the effects of overactive bladder (OAB) syndrome symptoms on female sexual function. MATERIALS AND METHODS: 40 patients with OAB symptoms and 40 age-matched women as a control group were evaluated using the Female Sexual Function Index (FSFI) for sexual function. According to the presence of urge incontinence, women with OAB were also divided into wet and dry groups. After completion of the forms, groups were compared. RESULTS: Although scores of all domains of FSFI (desire, arousal, lubrication, orgasm, satisfaction, pain and total) in the OAB group were found to be lower than in the control group, only 'desire' was found to be significantly different (p = 0.035). The FSFI scores of the OAB-dry and OAB-wet group were similar to each other. CONCLUSION: The results indicate that there is a trend toward lower sexual function scores in women with OAB compared to controls.     

Sexual function in women after surgery for pelvic organ prolapse

Our objective was to evaluate the effect of surgical repair of pelvic organ prolapse on female sexual function. Sixty seven women with pelvic organ prolapse were recruited in the study. Degree of pelvic organ prolapse was assessed using pelvic organ prolapse quantitation (POPQ) staging system. Female sexual function index (FSFI) questionnaire was used to assess sexual function of the cases preoperatively and 12–16 weeks after the operation. Mean age of the cases was 36.03 ± 5.38 years. The total mean FSFI score increased from 15.9 ± 10.7 to 21.9 ± 11.1 (P < 0.05). Domain scores of desire, arousal, lubrication, orgasm, and satisfaction were increased significantly (P < 0.05). The mean score for the pain-free intercourse decreased significantly. Results demonstrated that sexual function was improved postoperatively. Using various instruments to assess female sexual function and differences in demographic and cultural characteristics of study groups might be the reasons of discrepancy between the reports.     

The effect of mode of delivery on postpartum sexual functioning in primiparous women

The objective of this paper is to evaluate the effect of mode of delivery on postpartum sexual functioning in primiparous women. A total of 248 primiparous women were recruited into this study. One hundred fifty-six delivered spontaneously with mediolateral episiotomy and 92 had elective cesarean section. Sexual function was evaluated by the Female Sexual Function Index, a validated questionnaire separately evaluating desire, lubrication, orgasm, satisfaction, and pain. Subjects were questioned relating their pre-pregnancy experiences during the first antenatal visit when the pregnancy was not more than six gestational weeks. The test was repeated 6 months postpartum. Statistical evaluation was carried out by SPSS for Windows v.11. In the vaginal delivery with mediolateral episiotomy group, there were significant decreases in the scores 6 months after delivery when compared to scores before pregnancy (p<0.001). In the cesarean section group, no difference was observed between pre-pregnancy and postpartum scores (p>0.05). When the two groups were compared, there was a significant difference between 6 months postpartum scores (p<0.001). Not only pain, but also other important aspects of sexual function, such as arousal, lubrication, orgasm, and satisfaction are affected by performing mediolateral episiotomy during vaginal delivery, well beyond the puerperal period. Concerning its effects on postpartum sexual functioning, a policy of restricting mediolateral episiotomy use should be adopted.     

Is Burch or mid-urethral sling better with abdominal sacral colpopexy?

Introduction and hypothesis  This study aims to compare the post-operative rates of stress urinary incontinence (SUI) after abdominal sacral colpopexy (ASC) with either Burch or mid-urethral sling, tension-free vaginal tape (TVT), or no anti-incontinence procedure. The null hypothesis was there would be no difference in SUI among groups. Methods  A cohort of women who had undergone ASC (n = 150) either alone or with an anti-continence procedure were analyzed to determine the rates of post-operative SUI. Statistically significant differences were evaluated with a Student’s t-test. Results  A total of 150 subjects were evaluated, with 115 having SUI preoperatively. Post-operatively, 10% (15/150) of all subjects had SUI. Subjects with preoperative SUI who had a Burch were more likely to have post-operative SUI than those who had a TVT (10 versus 0, p = 0.007). Conclusions  Burch and TVT procedures improve SUI symptoms in patients undergoing ASC. Mid-urethral slings performed with ASC have lower rates of post-operative SUI. Presented at the 34th American Urogynecologic Society Meeting, September 4–6, 2008, Chicago, Illinois     

Effect of tension-free vaginal tape and TVT-obturator on lower urinary tract symptoms other than stress urinary incontinence

Variable effects on lower urinary tract symptoms (LUTS) other than stress urinary incontinence (SUI) have been reported after tension-free vaginal tape (TVT). We measured the effect of TVT on LUTS using the American Urological Association Symptom Index (AUASI). Patients undergoing TVT completed the AUASI pre- and post-operatively. Total scores (TS), storage scores (SS), and voiding scores (VS) were compared overall and among patients with SUI vs mixed urinary incontinence (MUI) and those who underwent TVT vs TVT-obturator (TVT-O). The mean change in TS and SS was −3.6 and −3.0. Mean reductions in TS and SS were significant in all patient subsets with no change in VS. There was no significant difference in the mean changes in TS between patients with SUI vs MUI or those undergoing TVT vs TVT-O. LUTS are improved after TVT in most patients. In general, voiding symptoms were not adversely affected.     

Prevalence and degree of sexual dysfunction in a sample of women seeking bariatric surgery

BackgroundSexual functioning has been shown to be impaired in women who are obese, particularly those seeking bariatric surgery. However, most previous studies evaluating sexual function in these populations have not used validated measures. We used the validated Female Sexual Function Index (FSFI) to assess the prevalence of female sexual dysfunction (FSD) in a sample of >100 women evaluated for bariatric surgery.MethodsThe FSFI was administered to reportedly sexually active women during their preoperative evaluation. The scores for the individual FSFI domains (desire, arousal, lubrication, orgasm, satisfaction, and pain) ranging from 0 (or 1.2) to 6 were summed to produce a FSFI total score (range 2–36). A FSFI total cutoff score of ≤26.55 was used to identify participants with FSD. The participants' FSFI total and domain scores were compared with previously published norms available for women diagnosed with female sexual arousal disorder and healthy controls.ResultsOf the 102 women, 61 (59.8%) had FSFI total scores of ≤26.55, indicative of FSD. Older age and menopause were associated with FSD. Compared with published norms, bariatric surgery candidates had FSFI domain scores that were lower than those of the control group (all P values < 0.0001) but greater than those of the female sexual arousal disorder group (all P values < 0.0001), except for desire, for which the scores were similar.ConclusionWomen seeking bariatric surgery are clearly a population with substantial sexual function impairment, with 60% of participants reporting FSD. These findings highlight the need to initiate routine assessment of sexual functioning in this population and examine whether the weight loss after bariatric surgery contributes to a reversal of FSD.     

Tension-Free Vaginal Tape Versus Transobturator Suburethral Tape: Five-Year Follow-up Results of a Prospective,Randomised Trial

Background

Many studies have assessed the equivalent effectiveness of tension-free vaginal tape (TVT) and transobturator suburethral tape (TVT-O) at short- to medium-term follow-up, but no long-term randomised trials appear in the literature.

Objective

We compared the use of TVT to TVT-O, providing a longer follow-up than currently appears in the literature.

Design, setting, and participants

Seventy-two consecutive patients affected by stress urinary incontinence (SUI) were included in this randomised, controlled trial. Patients were randomly allocated to the TVT or TVT-O procedure using a predetermined, computer-generated randomisation code.

Intervention

After preoperative assessment, patients were randomly allocated to the TVT or TVT-O procedure.

Measurements

This 5-yr study represents the extension of our original randomised trial, which was designed to assess the incidence of long-term complications (primary end point) and successes (secondary end point) for both techniques.

Results and limitations

At 60-mo follow-up, 52 patients (72%) were objectively cured of SUI (72.9% after TVT-O and 71.4% after TVT), but only 44 patients (61%) were satisfied. The late complication rate was 16.6% (10 women): five women (16.1%) in the TVT-O group and five women (17.2%) in the TVT group (p = 1). In this follow-up, 62% of the patients from the TVT-O group and 60% from the TVT group (p = 1) expressed that they were satisfied or very satisfied with the results. The mean cause of dissatisfaction was the development of sexual dysfunction resulting from dyspareunia or incontinence during intercourse, which was found in 6 of 16 dissatisfied patients (37.5%). The limitations of our study included the adequate but small sample size and the lack of questionnaires.

Conclusions

Both surgical techniques are safe, with similar results (72.9% and 71% of patients objectively cured after TVT-O and TVT, respectively) and low complication rates (16.6%: 16.1% and 17.2%, respectively, for TVT-0 and TVT), even after 5-yr follow-up.     

TVT与TVT-0治疗女性压力性尿失禁的疗效比较

目的比较经阴道无张力尿道吊带术(TVT)与经闭孔阴道中段尿道吊带术(TVT-O)治疗女性压力性尿失禁的疗效和安全性,探讨手术对于患者生活质量的影响。方法 87例压力性尿失禁患者按手术方式分为两组,TVT组46例,TVT-0组41例,分别行TVT术和TVT-O术治疗。术后采用自制问卷对两组患者治疗效果以及手术前和手术后6个月~1年的生活质量进行评定。结果两组手术时间分别为(26.2±4.6)min和(20.6土3.1)min,TVT组长于TVT-O组,差异具有统计学意义(P0.05)。两种方法均有效改善患者尿失禁症状,两组治愈率及并发症发生率比较差异均无统计学意义(P0.05);手术后两组患者的情绪、睡眠、饮食和社交活动情况均较术前有明显改善(P0.05),而性生活方面改善不明显。结论 TVT及TVT-0治疗女性压力性尿失禁的疗效及安全性相似,均能有效提高女性患者的生活质量。