To evaluate changes in female sexual function after a transobturator vaginal tape (TOT) procedure for treating genuine stress urinary incontinence (SUI), and its correlation with patient's expectation.
The study included women treated with a suburethral TOT for genuine SUI, neurologically intact, heterosexual and married, aged >18 years, with no previous history of malignancy, pelvic radiotherapy and no other associated surgical or psychological diseases. Patients were interviewed before surgery and with the aid of a questionnaire including female sexual function, the Beck depression indices and their expectation of sexual function after surgery.
Sixty-two premenopausal sexually active women were included (mean age 40.5 years). The cure rate from SUI was 92%, 89%, 87% and 84% at 6, 12, 18 and 24 months, respectively. All patients attended the visit before and the first visit after surgery, while 71%, 42% and 24% were assessed at the 12-, 18 and 24-month visits, respectively. The mean follow-up was 12 months. Fifty-two women resumed their sexual activity early within the 8 weeks after surgery and the frequency of coitus in more than two-thirds of patients was at least once per month. The number of women who expected either looseness or tightness of the vagina was more than that estimated from patient perceptions. There was a difference between the patient's sensation of vaginal length abnormalities during coitus (two women) and patient expectation (18 women).
Although the TOT is effective for treating SUI, counselling the patient and her partner is important in correcting false ideas and expectations about future sexual activity. Indeed, sexual dysfunction is reported after vaginal surgery, with a physiological and psychological background. Further assessment should be used to characterize sexual dysfunction after vaginal surgery for SUI to find new solutions.