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.
Similar content being viewed by others
References
Baessler K, Stanton SL (2004) Does Burch colposuspension cure coital incontinence? Am J Obstet Gynecol 190:1030–1033
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 99:281–289
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 24:221–229
Berglung AL, Fugl-Meyer KS (1996) Some sexological characteristics of stress incontinent women. Scand J Urol Nephrol 30:207–212
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 37:30–35
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 72:52–57
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 30:333–341
Digesu GA, Chaliha C, Salvatore S, Hutchings A, Khullar V (2005) The relationship of vaginal prolapse severity to symptoms and quality of life. BJOG 112:971–976
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 51:1–6
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 83:965–968
Haase P, Skibsted L (1988) Influence of operations for stress incontinence and/or genital descensus on sexual life. Acta Obstet Gynecol Scand 67:659–661
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 191:751–756
Hilliges M, Falsoner C, Ekman-Orderberg G (1995) Innervations of the vaginal mucosa as revealed by PGP9.5 immunohistochemistry. Acta Anat 153:119–126
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 84:79–84
Iskander MN, Kapoor DS, Mohammed A (2003) Subjective outcomes of the TVT procedure. Int J Gynaecol Obstet 83:69–70
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 17:39–57
Lemack G, Zimmern P (2000) Sexual function after vaginal surgery for stress incontinence. Results of a mail questionnaire. Urology 56:223–227
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 90:540–543
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 111:456–462
Olsen AL, Smith VJ, Bergstrom JO, Colling JC, Clark AL (1997) Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol 89:501–506
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 47:366–375
Roose SP, Glassman AH, Seidman SN (2001) Relationship between depression and other medical illnesses. JAMA 286:1687–1690
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 26:191–208
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 45:642–648
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 65:270–274
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 42:432–440
Stanton SL (1990) Surgical management of urethral sphincter incompetence. Clin Obstet Gynecol 33:346–357
Stenberg A, Heimer G, Ulmsten U, Cnattingius S (1996) Prevalence of genitourinary and other climacteric symptoms in 61-year-old women. Maturitas 24:31–36
Thakar R, Mayonda I, Stanton SL (1997) Bladder, bowel, and sexual dysfunction after hysterectomy for benign conditions. Br J Obstet Gynaecol 104:983–987
Tunuguntla HS, Gousse AE (2006) Female sexual dysfunction following vaginal surgery: a review. J Urol 175:439–446
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Çayan, F., Dilek, S., Akbay, E. et al. Sexual function after surgery for stress urinary incontinence: vaginal sling versus Burch colposuspension. Arch Gynecol Obstet 277, 31–36 (2008). https://doi.org/10.1007/s00404-007-0418-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00404-007-0418-1