[Sexual function after transobturator tape procedure for stress urinary incontinence and overall patients' satisfaction]

Abstract

Objective: To evaluate the quality of sexual activity after a transobturator tape procedure for urinary incontinence and to examine the global satisfaction reported by patients.

Materials and methods: This is a bicentric retrospective study, postoperative questionnaires were sent to 247 women operated for urinary incontinence by TOT/TVT-O surgery, after 1 year, prolaps were excluded. Patients' overall improvement was assessed using the French version of Patient Global Impression and Improvement (PGI-I), urinary symptoms were assessed with the use of ICIQ-Fluts and quality of sexual function using Lemack and Zimmern questionnaire and ICIQ-Fluts-Sex. A logistic regression analysis was run to analyse the factors associated with women overall improvement.

Results: One hundred and sixty-five patients answered the questionnaire (66.8%). Average age was 55 (±11), and the average postoperative period was 39 months (±17.9). After surgery, according to the

Pgi-i: 135 women (81.8%) found an overall improvement, 22 (13.4%) found their condition unchanged and 8 (4.8%) women found it worse. Among the 165 women, 118 were sexually active, 37 (31.4%) reported improvement in intercourse satisfaction whereas 11 (9.3%) complained about sexual function deterioration and 70 (59.3%) felt unchanged. The 37 women who reported sexual improvement described decreased coital incontinence in 54% of the cases. Eleven women who felt sexually worse, reported dyspareunia. Results of the logistic regression analysis suggested that overall improvement after surgery depended not only on the incontinence score (OR 0.83) but also on the quality of the postoperative sexual activity (OR 12.96).

Conclusion: One third of the women reported improvement of their sexuality after transobturator tape procedure. In fact, global satisfaction after surgery was as related to the improvement of urinary symptoms as it was to the quality of the sexual activity.

Level of evidence: 5.

Keywords: Bandelette sous-urétrale; Coital incontinence; Dyspareunia; Dyspareunie; Incontinence urinaire coïtale; Incontinence urinaire d’effort; Sexual function; Sexualité postopératoire; Stress urinary incontinence; Transobturator tape procedure.