title: Effect of sacral neuromodulation on female sexual function and quality of life: Are they correlated?
abstract: BACKGROUND
  Sacral neuromodulation (SNM) has become an established therapy for voiding dysfunction. Additional benefits, such as improved bowel functions and bladder pain, have been reported. Improvement in female sexual function after SNM treatment has been suggested; however, reports examining the effects of SNM on female sexual functions are scarce. We evaluate the effects of SNM on female sexual function and its impact on quality of life and analyze any correlation.
  
  
  METHODS
  Data were collected from January 2010 to May 2012 for all female patients who underwent SNM InterStim (Medtronic, Minneapolis, MN) therapy at a single centre in Canada. They were treated for voiding dysfunction, including refractory over-active bladder, frequency-urgency syndrome and non-obstructive urinary retention. Patients were screened by percutaneous nerve evaluation (PNE) to assess their response to therapy using a 4-day voiding diary. Patients who experienced 50% or more improvement in their voiding parameters were permanently implanted. All patients completed the Female Sexual Function Index (FSFI), Short-Form Health Survey (SF-36), and incontinence questionnaires (Urinary Distress Inventory [UDI]-6) preoperatively and 4 months postoperatively.
  
  
  RESULTS
  A total of 33 female patients had SNM therapy; 10 were excluded from the study because they were not sexually active. The indications were: refractory overactive bladder in 19, frequency-urgency syndrome in 2, and non-obstructive urinary retention in another 2 patients. SNM therapy significantly improved the total FSFI score (p = 0.011); the components of desire and orgasm showed significant improvement (p = 0.014 and p = 0.035, respectively). Age, body mass index, diagnosis, and urinary symptoms did not show significant correlation with FSFI score improvement. Quality of life showed significant improvement after SNM treatment in 5 categories. There was no correlation between improvement in quality of life and FSFI.
  
  
  CONCLUSIONS
  SNM may improve female sexual function and quality of life, yet there is no correlation between the improvement in FSFI and quality of life.
authors.affiliation: Department of Urology, King Abdulaziz University, Faculty of Medicine, Jeddah, Kingdom of Saudi Arabia;
authors.forename: Mai
authors.initials: M
authors.lastname: Banakhar
authors.affiliation: Department of Urology, King Abdulaziz University, Faculty of Medicine, Jeddah, Kingdom of Saudi Arabia;
authors.forename: Yahya
authors.initials: Y
authors.lastname: Gazwani
authors.affiliation: Department of Urology, King Abdulaziz University, Faculty of Medicine, Jeddah, Kingdom of Saudi Arabia;
authors.forename: Mohamed El
authors.initials: ME
authors.lastname: Kelini
authors.affiliation: Department of Urology, University of Toronto, Toronto Western Hospital, Toronto, ON.
authors.forename: Tariq
authors.initials: T
authors.lastname: Al-Shaiji
authors.affiliation: Department of Urology, University of Toronto, Toronto Western Hospital, Toronto, ON.
authors.forename: Magdy
authors.initials: M
authors.lastname: Hassouna