Sexual Function Improves in Women Who Have Had Anti-Incontinence Surgery

By Reuters Staff

February 05, 2020

NEW YORK (Reuters Health) - Surgery for stress incontinence is associated with significant improvements in female sexual function through 24 months after surgery, according to a secondary analysis of two clinical trials.

Between a quarter and half of adult women have urinary incontinence, and female sexual dysfunction rises in parallel with the severity of stress urinary incontinence. Whether anti-incontinence surgery in women improves sexual function remains unclear.

To investigate, Dr. Stephanie M. Glass Clark and colleagues from Virginia Commonwealth University Health System, in Richmond, used data from the SISTEr and TOMUS trials, which compared Burch colposuspension versus autologous fascial sling and retropubic versus transobturator midurethral slings.

Among the 924 sexually active women who completed the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ)-12 at baseline, 12-month follow-up, or 24-month follow-up, there were significant improvements in sexual function scores at both follow-ups compared with baseline, regardless of the type of anti-incontinence surgery.

There were clinically meaningful improvements in overall sexual function, as well as in specific conditions, including recurrent incontinence, prolapse, pain and various sexual function domains (physical, behavioral or emotive, and partner).

Most of the improvement in sexual function occurred in the first 12 months after surgery and was maintained over the second postoperative year, the researchers report in Obstetrics and Gynecology.

Postoperative failure was significantly associated with worse sexual function scores, whereas concomitant prolapse-repair surgery was significantly associated with better sexual function scores after surgery.

The greatest improvement in sexual function from baseline to postoperatively was seen in the specific questions "are you incontinent of urine with sexual activity?" and "does fear of incontinence restrict your sexual activity?"

"These data contribute to the growing body of literature of postoperative sexual function after four commonly performed anti-incontinence procedures," the authors conclude. "This study and others demonstrate that sexual function improves with surgical improvement of stress incontinence which may suggest a possible association of urinary incontinence and sexual dysfunction."

Dr. Glass Clark did not respond to a request for comments.

SOURCE: Obstetrics & Gynecology, February 2020.