Abstract

We aimed to evaluate the effect of mesh-urethra distance on sexual functions in continent patients who underwent transobturator tape (TOT) surgery due to isolated stress urinary incontinence.

Eighty-two continent patients who had undergone TOT surgery for stress urinary incontinence were included in the study. Objective treatment for stress urinary incontinence was defined as the absence of urine leakage during a stress test. Translabial perineal ultrasound was performed 6 months after the surgery. The successful surgical group was split into two subgroups based on the distance from the posterior of the urethra at the bladder neck to the nearest proximal edge of the tape: < 5 mm and > 5 mm. In addition to these, band percentile, the descent of bladder neck and urethra length measured by perineal ultrasound, pubo-urethral distance, urethral thickness, detrusor thickness, cystocele descent, rectal descent, and uterine descent were evaluated. Preoperative and postoperative results of the standardized and internationally valid incontinence questionnaires Incontinence Questionnaire Urinary Incontinence Short Form (ICIQ-UI SF) and Female Sexual Function Index (FSFI) were compared between groups.

The postoperative FSFI scores for the > 5-mm group were statistically significantly lower than those of the < 5-mm group, including the postoperative FSFI average, all subscales except lubrication, and average change scores due to the operation (p < .001). There was no statistically significant relationship between the percentile it occupied and postoperative FSFI level (p = .553), and FSFI preoperative–postoperative difference was not significant (p = .905).

Sexual functions are more affected in patients with a mesh-urethra distance > 5 mm as observed via perineal ultrasound.

Keywords: Transobturator tape, transperineal ultrasound, female stress incontinence, sexualiy