Impact of vaginal surgery for stress urinary incontinence on female sexual function: is the use of polypropylene mesh detrimental?
OBJECTIVE
To evaluate prospectively the impact of a distal urethral polypropylene sling on sexual function using a validated questionnaire. Suburethral slings are currently the most common anti-incontinence surgery performed. Although the use of polypropylene is safe and effective, concern exists that the presence of the material in the vagina may adversely affect sexual function.


METHODS
A total of 29 patients agreed to participate in this prospective study. The patients were evaluated with the Female Sexual Function Index, a validated, 19-item questionnaire that assesses six domains of sexual function: desire, arousal, lubrication, orgasm, satisfaction, and pain. The questionnaires were administered at 6-month intervals during the follow-up visits.


RESULTS
The mean patient age was 52 years (range 38 to 72). The mean duration of follow-up was 19.4 months (range 7 to 37). No statistically significant difference was found in sexual function after placement of a distal urethral polypropylene sling. Of the 29 patients, 14% were not sexually active before or after surgery. No statistically significant difference was found between preoperative and postoperative desire, arousal, lubrication, orgasm, satisfaction, and pain.


CONCLUSIONS
No change was found in overall sexual function in women undergoing placement of a mid to distal polypropylene urethral sling. Specifically, neither a deleterious effect nor statistically significant improvement was found in sexual desire, arousal, lubrication, orgasm, satisfaction, or pain compared with the preoperative baseline values.
Shah
Sovrin M
SM
Department of Urology, University of California, Los Angeles, Geffen School of Medicine, Los Angeles, California 90024, USA.
Bukkapatnam
Raviender
R
Rodríguez
Larissa V
LV
D000328:Adult; D000368:Aged; D004414:Dyspareunia / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007045:Hysterectomy, Vaginal; D007989:Libido; D008875:Middle Aged; D009948:Orgasm; D010549:Personal Satisfaction; D011126:Polypropylenes; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology*; D011446:Prospective Studies; D019736:Prostheses and Implants / Q000009:adverse effects*; D020047:Rectocele / Q000150:complications / Q000601:surgery; D012735:Sexual Dysfunction, Physiological / Q000453:epidemiology / Q000209:etiology*; D013526:Surgical Mesh / Q000009:adverse effects*; D011795:Surveys and Questionnaires; D001745:Urinary Bladder Diseases / Q000150:complications / Q000601:surgery; D014550:Urinary Incontinence, Stress / Q000601:surgery*
D011126:Polypropylenes