title: Sexual function following surgery for urodynamic stress incontinence.
abstract: The objective of this study was to compare sexual function in women before and after surgery for urodynamic stress incontinence in the absence of pelvic organ prolapse. This was a prospective questionnaire survey. Fifty-four women undergoing surgery (tension-free vaginal tape/tension-free vaginal tape-obturator) for urodynamic stress incontinence with no evidence of detrusor overactivity or concomitant prolapse were assessed preoperatively and 6 months post operatively. Assessment was based on the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ), the International Consultation on Incontinence Questionnaire (ICIQ) and the Patient Global Impression of Improvement. Paired t-tests were used for comparing pre- and post-op scores and unpaired t-tests for comparing observations between groups. Spearman's rank correlation was used for testing whether two numerically scored items were related, and McNemar test was used to compare pre- and postoperative responses to individual questions. ICIQ scores showed significant improvement after surgery (p < 0.001). Women completing PISQ were significantly younger (mean = 54) than those who did not (mean = 65; p < 0.001). The total PISQ score was better postoperatively (preoperative = 87.2, postoperative = 92.7; p < 0.001), with improvements in both the physical (preoperative = 31.0, postoperative = 35.2; p < 0.001) and partner-related domains (preoperative = 18.8, postoperative = 19.9; p = 0.002) but no improvement in behaviour emotive domains (preoperative = 37.3, postoperative = 37.6; p = 0.70). There was a reduction in episodes of coital incontinence postoperatively (preoperatively = 16/54, postoperatively = 39/54; p < 0.002). Previous vaginal surgery, oestrogen status of respondents and hysterectomy status did not affect the PISQ. Surgical correction of stress incontinence is associated with an improvement in sexual function.
authors.affiliation: Urogynaecology Department, Birmingham Women's Hospital, Metchley Park Road, Birmingham, B15 2TG, UK. swatijha83@hotmail.com
authors.forename: Swati
authors.initials: S
authors.lastname: Jha
authors.forename: Paul
authors.initials: P
authors.lastname: Moran
authors.forename: Helen
authors.initials: H
authors.lastname: Greenham
authors.forename: Caroline
authors.initials: C
authors.lastname: Ford
mesh_terms: D000328:Adult; D000368:Aged; D003075:Coitus / Q000523:psychology; D005260:Female; D006801:Humans; D008875:Middle Aged; D011184:Postoperative Period; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D014550:Urinary Incontinence, Stress / Q000523:psychology / Q000601:surgery*