title: The Impact of Midurethral Sling Surgery on Sexual Activity and Function in Women With Stress Urinary Incontinence.
abstract: Stress urinary incontinence has a negative impact on sexual function.
  
  
  
  To assess the effect of midurethral sling surgery on sexual activity and function in women with stress urinary incontinence.
  
  
  
  This is a secondary analysis of the Value of Urodynamics Prior to Stress Incontinence Surgery (VUSIS-II) study, which assessed the value of urodynamics in women with (predominantly) stress urinary incontinence. Patients who underwent retropubic or transobturator sling surgery were included in the present study if information was available on sexual activity before and 12 months after surgery. Data were collected from a self-report validated questionnaire combined with non-validated questions. The association between midurethral sling surgery and sexual function (coital incontinence, satisfaction, and dyspareunia) was compared with McNemar χ(2) tests for nominal data and paired t-tests for ordinal data. Potentially influential factors were analyzed with univariable and multivariable logistic regression analyses.
  
  
  
  Changes in sexual activity and sexual function after midurethral sling surgery.
  
  
  
  Information on sexual activity was available in 293 of the 578 women (51%) included in the VUSIS-II study. At baseline, 252 of 293 patients (86%) were sexually active vs 244 of 293 (83%) after 12 months. More patients with cured stress urinary incontinence were sexually active postoperatively (213 of 247 [86%] vs 31 of 46 [67%], P < .01). There was a significant decrease in coital incontinence (120 of 236 [51%] preoperatively vs 16 of 236 [7%] postoperatively, P < .01). De novo dyspareunia was present in 21 of 238 women (9%). There was a greater improvement in coital incontinence after placement of the retropubic sling compared with the transobturator sling (odds ratio = 2.04, 95% CI = 1.10-3.80, P = .02).
  
  
  
  These data show that midurethral sling surgery has an overall positive influence on sexual function in women with stress urinary incontinence. The retropubic sling is more effective than the transobturator sling for improvement of coital incontinence. De novo dyspareunia was present in 1 of 11 women.
authors.affiliation: Department of Obstetrics and Gynecology, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Obstetrics and Gynecology, Rijnstate Hospital, Arnhem, The Netherlands. Electronic address: Bianca.Mengerink@radboudumc.nl.
authors.forename: Bianca B
authors.initials: BB
authors.lastname: Mengerink
authors.affiliation: Department of Obstetrics and Gynecology, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Sanne A L
authors.initials: SA
authors.lastname: Van Leijsen
authors.affiliation: Department of Obstetrics and Gynecology, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Mark E
authors.initials: ME
authors.lastname: Vierhout
authors.affiliation: Radboud Institute for Health Sciences, Department for Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Joanna
authors.initials: J
authors.lastname: Inthout
authors.affiliation: The Robinson Institute, School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide, Australia.
authors.forename: Ben W J
authors.initials: BW
authors.lastname: Mol
authors.affiliation: Department of Obstetrics and Gynecology, Reinier de Graaf Group, Delft, The Netherlands.
authors.forename: Alfredo L
authors.initials: AL
authors.lastname: Milani
authors.affiliation: Department of Obstetrics and Gynecology, Academic Medical Center Amsterdam, Amsterdam, The Netherlands.
authors.forename: Jan-Paul W R
authors.initials: JP
authors.lastname: Roovers
authors.affiliation: Department of Obstetrics and Gynecology, Isala Klinieken, Zwolle, The Netherlands.
authors.forename: Hugo W F
authors.initials: HW
authors.lastname: Van Eijndhoven
authors.affiliation: Department of Obstetrics and Gynecology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Carl H
authors.initials: CH
authors.lastname: Van Der Vaart
authors.affiliation: Department of Obstetrics and Gynecology, VieCuri, Venlo, The Netherlands.
authors.forename: Iris
authors.initials: I
authors.lastname: Van Gestel
authors.affiliation: Department of Obstetrics and Gynecology, Rijnstate Hospital, Arnhem, The Netherlands.
authors.forename: Francis E
authors.initials: FE
authors.lastname: Hartog
authors.affiliation: Department of Obstetrics and Gynecology, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: John F A
authors.initials: JF
authors.lastname: Heesakkers
authors.affiliation: Department of Obstetrics and Gynecology, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Kirsten B
authors.initials: KB
authors.lastname: Kluivers
mesh_terms: D000328:Adult; D004414:Dyspareunia / Q000209:etiology; D005260:Female; D006801:Humans; D008875:Middle Aged; D016017:Odds Ratio; D012725:Sexual Behavior / Q000523:psychology*; D012735:Sexual Dysfunction, Physiological / Q000209:etiology* / Q000523:psychology; D012747:Sexual Partners / Q000523:psychology; D053825:Suburethral Slings / Q000009:adverse effects* / Q000523:psychology; D011795:Surveys and Questionnaires; D014549:Urinary Incontinence / Q000601:surgery; D014563:Urodynamics; D013520:Urologic Surgical Procedures / Q000009:adverse effects* / Q000523:psychology; D016387:Women's Health
keywords: Incontinence Surgery; Midurethral Sling; Midurethral Sling Surgery; Retropubic Sling; Sexual Activity; Sexual Function; Sexuality; Stress Urinary Incontinence; Transobturator Sling; Value of Urodynamics Prior to Stress Incontinence Surgery (VUSIS) I and II