Sexual activity before and after mid urethral sling. A prospective multicentre study

Aim of the study: Aim of this multicentre study is to evaluate the sexual activity in a group of women with urodynamic stress incontinence (USI)treated with Mid-Urethral Sling (MUS) procedure. Material and methods: From September 2004 to April 2009, 133 women complaint of IUS underwent to MUS, 105 to a trans-obturator procedure (TOT) e 28 retropubic (TVT), were included in the study.All women underwent urogynecologic evaluation, bladder diary, urynalisis, ultrasound and urodynamic study. All women answered to an Italian translation of FSFI before surgery and 6‑12 months after surgery. We considered cured all the patients that referred no urine loss, no pads use and had had a negative stress test. Patients satisfaction were measured with a VAS, where 1 was the minimum of satisfaction and 10 was the maximum. Statistical analysis were made with Mann‑Whitney and Wilcoxon tests and Spearman's correlation coefficient.We use multivariate analysis to evaluate the significant and independent variables. Results: 53/133 (39%) did not have an active sexual life before surgery. Pre-operative results demonstrated a normal sexual activity (FSFI total score > 26.55) in 35/80 (43%) of women. 12 months after surgery 37/53 women which did not have an active sexual life before surgery restored their sexual activity. Instead of 7/80 sexual active before surgery did not 12 months after operation. 46/96 (47%) of sexual active women after surgery had a normal sexuality (FSFI total score > 26.55). Comparison of FSFI total score and all questionnaire sub-score demonstrated a significant improvement of sexual function in the patients that underwent either to TVT and TOT (p<0.0001) procedure, without difference between the two approach (p>0.05). 78% of patients declared satisfaction and would repeat the procedure. We did not find significant any after surgery. A statistical significant correlation was found between FSFI total score and instruction level, menopause, continence status, and storage dysfunction after surgery. After multivariate analysis only menopause and storage symptoms remained significant and independent variables. Discussion: Sexual function is an important parameter of female quality of life and is mandatory it's evaluation in women treated for ius. Conclusion: The patients that underwent to a sling procedure for IUS had a significant improvement of their sexuality.