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Archives of Gynecology and Obstetrics

, Volume 277, Issue 1, pp 31–36 | Cite as

Sexual function after surgery for stress urinary incontinence: vaginal sling versus Burch colposuspension

  • Filiz Çayan
  • Saffet Dilek
  • Erdem Akbay
  • Selahittin Çayan
Original Article

Abstract

Objective

We prospectively investigated the effect of surgery for stress urinary incontinence (SUI) on sexual function and also compared preoperative and postoperative sexual functions according to vaginal or abdominal surgery for SUI.

Methods

The study included 94 women who underwent surgery for SUI, and the women were divided into two groups: 53 women had vaginal sling, and 41 women had Burch colposuspension. Female sexual function was evaluated with a detailed 19-item questionnaire, the female sexual function index (FSFI), including sexual desire, arousal, lubrication, orgasm, satisfaction, and pain. In all women, sexual function was compared before and after surgery for SUI, and the differences in postoperative sexual functions were also compared between the women undergoing vaginal sling and Burch colposuspension.

Results

In all women, total sexual function score significantly decreased from 20.8 ± 9 to 17.3 ± 9.3 after surgery (P = 0.000). Total sexual function score decreased from 19.2 ± 10 to 17.2 ± 9.9 in the vaginal sling group and decreased from 23.6 ± 6.2 to 17.6 ± 7.7 in the Burch colposuspension group, revealing significant difference between the two groups (P = 0.011). Statistically significantly higher decreases in postoperative sexual desire (P = 0.014), arousal (P = 0.026), lubrication (P = 0.004), and orgasm scores (P = 0.008) were also observed in the Burch colposuspension group than in the vaginal sling group. Based on total score, postoperative sexual function improved in 13 women (24.5%) of the vaginal sling group and in 5 women (12.2%) of the Burch colposuspension group, remained unchanged in 15 (28.3%) and 10 (24.4%), respectively, and deteriorated in 25 (47.2%) and 26 (63.4%), respectively.

Conclusion

Our findings show that sexual functions may be impaired after surgery for SUI. Burch colposuspension may deteriorate sexual functions much more than vaginal sling surgery in women. Therefore, women who will need surgery for SUI should be informed of the risk of deterioration of sexual function after surgery.

Keywords

Urinary incontinence Sexual function Surgery Vaginal sling Burch colposuspension 

References

  1. 1.
    Baessler K, Stanton SL (2004) Does Burch colposuspension cure coital incontinence? Am J Obstet Gynecol 190:1030–1033PubMedCrossRefGoogle Scholar
  2. 2.
    Barber MD, Visco AG, Wyman JF, Fantl JA, Bump RC (2002) Continence program for women research group: sexual function in women with urinary incontinence and pelvic organ prolapse. Obstet Gynecol 99:281–289PubMedCrossRefGoogle Scholar
  3. 3.
    Basson R, Leiblum S, Brotto L, Derogatis L, Fourcroy J, Fugl-Meyer K, et al (2003) Definitions of women’s sexual dysfunction reconsidered: advocating expansion and revision. J Psychosom Obstet Gynaecol 24:221–229PubMedGoogle Scholar
  4. 4.
    Berglung AL, Fugl-Meyer KS (1996) Some sexological characteristics of stress incontinent women. Scand J Urol Nephrol 30:207–212CrossRefGoogle Scholar
  5. 5.
    Bortolotti A, Bernardini B, Colli E, Benedetto PD, Nacci GG, Landoni M, Lavezzari M, Pagliarulo A, et al (2000) Prevalence and risk factors for urinary incontinence in Italy. Eur Urol 37:30–35PubMedCrossRefGoogle Scholar
  6. 6.
    Çayan S, Akbay E, Bozlu M, Canpolat B, Acar D, Ulusoy E (2004) The prevalence of female sexual dysfunction and potential risk factors that may impaire sexual function in Turkish women. Urol Int 72:52–57PubMedGoogle Scholar
  7. 7.
    Çayan S, Bozlu M, Canpolat B, Akbay E (2005) The assessment of sexual functions in women with male partners complaining of erectile dysfunction: does treatment of male sexual dysfunction improve female partner’s sexual functions? J Sex Marital Ther 30:333–341CrossRefGoogle Scholar
  8. 8.
    Digesu GA, Chaliha C, Salvatore S, Hutchings A, Khullar V (2005) The relationship of vaginal prolapse severity to symptoms and quality of life. BJOG 112:971–976PubMedCrossRefGoogle Scholar
  9. 9.
    Doruk E, Akbay E, Çayan S, Akbay E, Bozlu M, Acar D (2005) Effect of diabetes mellitus on female sexual function and risk factors. Arch Androl 51:1–6PubMedCrossRefGoogle Scholar
  10. 10.
    Glavind K, Tetsche MS (2004) Sexual function in women before and after suburethral sling operation for stress urinary incontinence: a retrospective questionnaire study. Acta Obstet Gynecol Scand 83:965–968PubMedCrossRefGoogle Scholar
  11. 11.
    Haase P, Skibsted L (1988) Influence of operations for stress incontinence and/or genital descensus on sexual life. Acta Obstet Gynecol Scand 67:659–661PubMedCrossRefGoogle Scholar
  12. 12.
    Handa VL, Harvey L, Cundiff GW, Siddique SA, Kjerulff KH (2004) Sexual function among women with urinary incontinence and pelvic organ prolapse. Am J Obstet Gynecol 191:751–756PubMedCrossRefGoogle Scholar
  13. 13.
    Hilliges M, Falsoner C, Ekman-Orderberg G (1995) Innervations of the vaginal mucosa as revealed by PGP9.5 immunohistochemistry. Acta Anat 153:119–126PubMedCrossRefGoogle Scholar
  14. 14.
    Helström L, Nilsson B (2005) Impact of vaginal surgery on sexuality and quality of life in women with urinary incontinence or genital descensus. Acta Obstet Gynecol Scand 84:79–84PubMedCrossRefGoogle Scholar
  15. 15.
    Iskander MN, Kapoor DS, Mohammed A (2003) Subjective outcomes of the TVT procedure. Int J Gynaecol Obstet 83:69–70PubMedCrossRefGoogle Scholar
  16. 16.
    Laumann EO, Nicolosi A, Glasser DB, Paik A, Gingell C, Moreira E, Wang T, GSSAB Investigators’ group (2005) Sexual problems among women and men aged 40–80 y: prevalence and correlates identified in the Global Study of Sexual Attitudes and Behaviours. Int J Impot Res 17:39–57PubMedCrossRefGoogle Scholar
  17. 17.
    Lemack G, Zimmern P (2000) Sexual function after vaginal surgery for stress incontinence. Results of a mail questionnaire. Urology 56:223–227PubMedCrossRefGoogle Scholar
  18. 18.
    Maaita M, Bhaumik J, Davies AE (2002) Sexual function after using tension-free vaginal tape for the surgical treatment of genuine stress incontinence. BJU Int 90:540–543PubMedCrossRefGoogle Scholar
  19. 19.
    Maas CP, ter Kuile MM, Laan E, Tuijnman CC, Weijenborg PhThM, Trimbos JB, Kenter GG (2004) Objective assessment of sexual arousal in women with a history of hysterectomy. BJOG 111:456–462Google Scholar
  20. 20.
    Olsen AL, Smith VJ, Bergstrom JO, Colling JC, Clark AL (1997) Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol 89:501–506PubMedCrossRefGoogle Scholar
  21. 21.
    Ponholzer A, Roehlich M, Racz U, Temml C, Madersbacher S (2005) Female sexual dysfunction in a healthy Austrian cohort: prevalence and risk factors. Eur Urol 47:366–375PubMedCrossRefGoogle Scholar
  22. 22.
    Roose SP, Glassman AH, Seidman SN (2001) Relationship between depression and other medical illnesses. JAMA 286:1687–1690PubMedCrossRefGoogle Scholar
  23. 23.
    Rosen R, Brown C, Heiman J, Leiblum S, Meston C, Shabsigh R, Ferguson D, D’Agostino R (2000) The female sexual function index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital Ther 26:191–208PubMedCrossRefGoogle Scholar
  24. 24.
    Salonia A, Zanni G, Nappi RE, Briganti A, Deho F, Fabbri F, et al (2004) Sexual dysfunction is common in women with lower urinary tract symptoms and urinary incontinence: results of a cross-sectional study. Eur Urol 45:642–648PubMedCrossRefGoogle Scholar
  25. 25.
    Shah SM, Bukkapatnam R, Rodriguez LV (2005) Impact of vaginal surgery for stress urinary incontinence on female sexual function: is the use of polypropylene mesh detrimental? Urology 65:270–274PubMedCrossRefGoogle Scholar
  26. 26.
    Shaw C (2002) A systematic review of the literature on the prevalence of sexual impairment in women with urinary incontinence and the prevalence of urinary leakage during sexual activity. Eur Urol 42:432–440PubMedCrossRefGoogle Scholar
  27. 27.
    Stanton SL (1990) Surgical management of urethral sphincter incompetence. Clin Obstet Gynecol 33:346–357PubMedCrossRefGoogle Scholar
  28. 28.
    Stenberg A, Heimer G, Ulmsten U, Cnattingius S (1996) Prevalence of genitourinary and other climacteric symptoms in 61-year-old women. Maturitas 24:31–36PubMedCrossRefGoogle Scholar
  29. 29.
    Thakar R, Mayonda I, Stanton SL (1997) Bladder, bowel, and sexual dysfunction after hysterectomy for benign conditions. Br J Obstet Gynaecol 104:983–987PubMedGoogle Scholar
  30. 30.
    Tunuguntla HS, Gousse AE (2006) Female sexual dysfunction following vaginal surgery: a review. J Urol 175:439–446PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Filiz Çayan
    • 1
  • Saffet Dilek
    • 1
  • Erdem Akbay
    • 2
  • Selahittin Çayan
    • 2
  1. 1.Department of Obstetrics and GynecologyUniversity of Mersin School of MedicineMersinTurkey
  2. 2.Department of UrologyUniversity of Mersin School of MedicineMersinTurkey

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