Female Sexual Function Evaluation of the Tension-Free Vaginal Tape (TVT) and Transobturator Suburethral Tape (TOT) Incontinence Surgery: Results of a Prospective Study

Abstract

Significantly more women reporting stress urinary incontinence (SUI) or low urinary tract symptoms complained of sexual dysfunction than a general healthy female population. The use of a tension-free vaginal tape (TVT), placed transvaginally under the mid-urethra, ensures to reacquire continence but could affect sexual function. This study aimed to determine if a suburethral tape for the correction of SUI could interfere with sexual activity. Of 108 patients, 37 underwent positioning of a tension free vaginal tape through a retropubic approach (TVT), and 71 through a transobturator approach from outside to inside (TOT). All patients enrolled had a complete urodynamic study and were invited to answer the Female Sexual Function Index questionnaire and our personal questionnaire, before surgery, after 1 month, and then at 3-month intervals. Of the 108 patients, 67% of the women experienced incontinence during intercourse, 96% during penetration, and 4% on orgasm. The cure rate for SUI was 97.1%. Sixty-two women (87%) with TOT placement and 31 (84%) with TVT were satisfied with the operation as regards sexual function, 68 (96%) and 29 (78%), respectively, with TOT and TVT had an improvement of urinary symptoms with resolution of urinary leakage during intercourse, after a 12.3-month follow-up. Just one patient treated with a TOT approach and two with the TVT complained of low grade of leakage. Of the 101 sexually active women, 90.1% reported a significant improvement in their sexual life, 9.9% referred a poor sexual activity not due to surgical intervention. In the surgical treatment of SUI, it is important to think about the patients' future sexual life and inform them that the great part of women can expect to improve their quality of life.