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Sexual function after suburethral sling removal for dyspareunia

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Abstract

Introduction

Impact on sexual function has received little attention in the medical literature for a long time. Because of the site of insertion of permanent tension free vaginal tape (TVT) the G spot might be affected or the tape might interfere with arousal and sensory stimulation. Recent studies have reported varying degrees of sexual impairment after TVT insertion ranging from 0% to 15% including dyspareunia.

Aim

The aim of this study was to evaluate sexual function before and after suburethral sling removal due to postoperative female de novo dyspareunia. As a secondary outcome, general patients’ satisfaction with their overall continence situation was assessed.

Patients and methods

Between December 2005 and December 2007, we included 18 female patients who complained of de novo dyspareunia after suburethral sling insertion for urinary stress incontinence. All patients filled in an FSFI questionnaire prior to sling removal and at 3 months postoperatively. Additionally, all women were asked to estimate their general satisfaction regarding their continence situation using a Visual Analogue Scale (VAS) from 0 to 10, with 0 being the least satisfying situation and 10 being the most satisfying situation. All patients underwent gynaecological examination including ICS-pelvic organ prolapse staging (ICS-POP score).

Results

Of the 18 slings, ten were transobturator tapes (6 × TVT-O, 2 × Monarch, 2 × unknown) and eight were retropubic tapes (7 × TVT, 1 × SPARC). Desire, arousal, lubrication, satisfaction, and pain improved statistically significant. Orgasm scores were low with median scoring of 1.5 scores before and 1.0 scores after sling removal, and they did not change significantly after sling removal. The satisfaction rate deteriorated from a median of 7 (95% confidence interval [CI] 6.3–7.7) to a median of 4 (95% CI 3.7–5.1; p = 0.99) but not statistically significant.

Conclusions

Sexual function in patients with de novo dyspareuina is likely to improve after sling removal but not in all domains. Bladder function may deteriorate.

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Authors and Affiliations

  1. Department of Obstetrics and Gynaecology, Bern University Hospital and University of Bern, Effingerstr. 102, CH-3010, Bern, Switzerland

    Annette Kuhn, Caroline Eggemann & Michael D. Mueller

  2. Department of Urology, Bern University Hospital and University of Bern, Bern, Switzerland

    Fiona Burkhard

Authors
  1. Annette Kuhn
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  2. Fiona Burkhard
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  3. Caroline Eggemann
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  4. Michael D. Mueller
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Correspondence to Annette Kuhn.

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Kuhn, A., Burkhard, F., Eggemann, C. et al. Sexual function after suburethral sling removal for dyspareunia. Surg Endosc 23, 765–768 (2009). https://doi.org/10.1007/s00464-008-0058-y

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  • DOI: https://doi.org/10.1007/s00464-008-0058-y

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