Evaluation of the differences in sexual functions of women who underwent transobturatuar tape surgery

Abstract

Aims: The study aims to determine the changes in sexual function and life of patients with stress urinary incontinence (SUI) and mixed type urinary incontinence (MUI) with transobturator tape (TOT) operation. Methods: 232 urinary incontinence patients who had only TOT surgery between the dates of May 2022- May 2023 were included in the study. Participants were similar in terms of demographic parameters. Participants completed several questionnaires, such as the Incontinence Impact Questionnaire (IIQ-7), Urogenital Distress Inventory (UDI-6), Female Sexual Function Index (FSFI), and the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12), both before surgery and six months post-operative. Results: While IIQ-7 and UDI-6 values, which measure the adverse effects of urinary incontinence, were 13.06±3.74, 7.03±2.61 preoperatively, they were 2.14±2.12 and 2.92±1.77 postoperatively. The FSFI values for evaluating female sexual function were 22.58±1.91 preoperatively and 26.62±1.80 postoperatively, respectively. The total value of the PISQ-12 questionnaire, which also evaluated sexual function, was 39.77±14.19 preoperatively and 46.61±0.97 postoperatively. There was a significant difference between the results of the surveys conducted before and after the operation.(p values: 0.0001, 0.0001, 0.0001, and 0.0001, respectively). Conclusion: Having a TOT operation affects the sexual function and life of patients suffering from SUI positively.

Keywords

• Female sexual life
• stress urinary incontinence
• trans obturator tape

Transobturatuar bant (TOT) ameliyatı geçiren kadınların cinsel fonksiyonlarındaki farklılıkların değerlendirilmesi

Abstract

Özet: Amaç: Çalışma, trans obturator bant (TOT) ameliyatı ile stres üriner inkontinans (SUI) ve mikst tip üriner inkontinans (MUI) hastalarında cinsel fonksiyon ve yaşamdaki değişikliklerin belirlenmesini amaçlamaktadır. Gereç ve yöntem: Mayıs 2022-Mayıs 2023 tarihleri arasında sadece TOT ameliyatı olan 232 idrar kaçırma hastası çalışmaya dahil edildi. Katılımcılar demografik parametreler açısından benzerdi. Katılımcılar ameliyat öncesi altıncı ayda İnkontinans Etki Anketi'ni (IIQ-7), Ürogenital Sıkıntı Envanteri'ni (UDI-6), Kadın Cinsel Fonksiyon İndeksi'ni (FSFI) ve Pelvik Organ Sarkması/İdrar Kaçırma Cinsel Anketi'ni (PISQ-12) doldurdular ve ameliyat sonrası. Bulgular: Üriner inkontinansın olumsuz etkilerini ölçen IIQ-7 ve UDI-6 değerleri ameliyat öncesi 13,06±3,74, 7,03±2,61 iken ameliyat sonrası 2,14±2,12 ve 2,92±1,77 olarak belirlendi. Kadın cinsel fonksiyonunu değerlendirmeye yönelik FSFI değerleri ameliyat öncesi sırasıyla 22,58 ± 1,91 ve ameliyat sonrası 26,62 ± 1,80 idi. Cinsel işlevi de değerlendiren PISQ-12 anketinin toplam değeri ameliyat öncesi 39,77±14,19, ameliyat sonrası 46,61±0,97 idi. Tüm değerler istatistiksel olarak anlamlıydı (p değerleri: sırasıyla 0,0001, 0,0001, 0,0001 ve 0,0001). Sonuç: TOT ameliyatı olmak SÜİ hastalarının cinsel fonksiyonlarını ve yaşamlarını olumlu yönde etkilemektedir.

Keywords

• kadın cinsel fonksiyonu
• üriner inkontinans
• transobturatuar tape (TOT)

References

1. 1. Ptak M, Brodowska A, Ciećwież S, Rotter I. Quality of life in women with stage 1 stress urinary incontinence after application of conservative treatment-a randomized trial. Int J Environ Res Public Health. 2017;14(6):577. doi:10.3390/ijerph14060577
2. 2. Liang CC, Tseng LH, Lo TS, Lin YH, Lin YJ, Chang SD. Sexual function following outside-in transobturator midurethral sling procedures: a prospective study. Int Urogynecol J. 2012;23(12):1693-1698. doi:10.1007/s00192-012-1792-1
3. 3. Dumoulin C, Cacciari LP, Hay-Smith EJC. Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. Cochrane Database Syst Rev. 2018;10(10):CD005654. doi:10.1002/14651858.CD005654.pub4
4. 4. Hevesi K, Mészáros V, Kövi Z, Márki G, Szabó M. Different characteristics of the female sexual function index in a sample of sexually active and inactive women. J Sex Med. 2017;14(9):1133- 1141. doi:10.1016/j.jsxm.2017.07.008
5. 5. Serati M, Salvatore S, Uccella S, Nappi RE, Bolis P. Female urinary incontinence during intercourse: a review on an understudied problem for women’s sexuality. J Sex Med. 2009;6(1):40-48. doi: 10.1111/j.1743-6109.2008.01055.x
6. 6. Ünal Ö, Karadeniz O. Comparison of laparoscopic versus open Burch colposuspension techniques for female stress or mixed urinary incontinence: a ten-year experience in a tertiary center. J Med Palliat Care. 2023;4(3):189-195.
7. 7. Fashokun TB, Harvie HS, Schimpf MO, et al. Sexual activity and function in women with and without pelvic floor disorders. Int Urogynecol J. 2013;24(1):91-97. doi:10.1007/s00192-012-1848-2
8. 8. Leone Roberti Maggiore U, Finazzi Agrò E, Soligo M, Li Marzi V, Digesu A, Serati M. Long-term outcomes of TOT and TVT procedures for the treatment of female stress urinary incontinence: a systematic review and meta-analysis. Int Urogynecol J. 2017;28(8):1119-1130. doi:10.1007/s00192-017-3275-x

9. 9. Uebersax JS, Wyman JF, Shumaker SA, McClish DK, Fantl JA. Short forms to assess life quality and symptom distress for urinary incontinence in women: the Incontinence Impact Questionnaire and the Urogenital Distress Inventory. Continence Program for Women Research Group. Neurourol Urodyn. 1995;14(2):131-139. doi:10.1002/nau.1930140206
10. 10.Cam C, Sakalli M, Ay P, Cam M, Karateke A. Validation of the short forms of the incontinence impact questionnaire (IIQ7) and the urogenital distress inventory (UDI-6) in a Turkish population. Neurourol Urodyn. 2007;26(1):129-133. doi:10.1002/nau.20292
11. 11.Rogers RG, Coates KW, Kammerer-Doak D, Khalsa S, Qualls C. A short form of the pelvic organ prolapse/urinary incontinence sexual questionnaire (PISQ-12). Int Urogynecol J Pelvic Floor Dysfunct. 2003;14(3):164-168.
12. 12.Cam C, Sancak P, Karahan N, Sancak A, Celik C, Karateke A. Validation of the short form of the pelvic organ prolapse/urinary incontinence sexual questionnaire (PISQ-12) in a Turkish population. Eur J Obstet Gynecol Reprod Biol. 2009;146(1):104- 107.
13. 13.Wiegel M, Meston C, Rosen R. The female sexual function index (FSFI): cross-validation and development of clinical cutoff scores. J Sex Marital Ther. 2005;31(1):1-20. doi:10.1080/00926230590475206
14. 14.Rosen R, Brown C, Heiman J, et al. The female sexual function index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital Ther. 2000;26(2):191–208.
15. 15.Aygin D, Aslan F. The Turkish adaptation of the female sexual function index. Turkiye Klinikleri J Med Sci. 2005;25(3):393–399.
16. 16.Karmakar D, Mostafa A, Abdel-Fattah M. Long-term outcomes of transobturator tapes in women with stress urinary incontinence: E-TOT randomised controlled trial. BJOG. 2017;124(6):973-981. doi:10.1111/1471-0528.14561
17. 17.Mota RL. Female urinary incontinence and sexuality. Int Braz J Urol. 2017;43(1):20-28. doi:10.1590/S1677-5538.IBJU.2016.0102
18. 18.Kamalak Z, Köşüş A, Hızlı F, Köşüş N, Hızlı D, Kafalı H. Does quality of female sexual function improve after a transobturator tape procedure?. J Obstet Gynaecol. 2014;34(6):512-514. doi:10.31 09/01443615.2014.911833
19. 19.Arts-de Jong M, van Altena AM, Aalders CI, Dijkhuizen FP, van Balken MR. Improvement of sexual function after transobturator tape procedure in women with stress urinary incontinence. Gynecol Surg. 2011;8(3):315-319. doi:10.1007/s10397-010-0643-7
20. 20.Bekker M, Beck J, Putter H, et al. Sexual function improvement following surgery for stress incontinence: the relevance of coital incontinence. J Sex Med. 2009;6(11):3208-3213. doi:10.1111/ j.1743-6109.2009.01395.x
21. 21.Ko YH, Song CH, Choi JW, Jung HC, Song PH. Effect on sexual function of patients and patients’ spouses after midurethral sling procedure for stress urinary incontinence: a prospective single center study. Low Urin Tract Symptoms. 2016;8(3):182-185. doi:10.1111/luts.12097
22. 22.Achtari C, McKenzie BJ, Hiscock R, et al. Anatomical study of the obturator foramen and dorsal nerve of the clitoris and their relationship to minimally invasive slings. Int Urogynecol J Pelvic Floor Dysfunct. 2006;17(4):330-334. doi:10.1007/s00192-005-0004-7
23. 23.Caruso S, Rugolo S, Bandiera S, Mirabella D, Cavallaro A, Cianci A. Clitoral blood flow changes after surgery for stress urinary incontinence: pilot study on TVT Versus TOT procedures. Urology. 2007;70(3):554-557. doi:10.1016/j.urology.2007.04.045
24. 24.Elzevier HW, Putter H, Delaere KP, Venema PL, Lycklama à Nijeholt AA, Pelger RC. Female sexual function after surgery for stress urinary incontinence: transobturator suburethral tape vs. tension-free vaginal tape obturator. J Sex Med. 2008;5(2):400-406. doi:10.1111/j.1743-6109.2007.00671.x
25. 25.Serati M, Salvatore S, Uccella S, et al. The impact of the midurethral slings for the treatment of stress urinary incontinence on female sexuality. J Sex Med. 2009;6(6):1534-1542. doi:10.1111/ j.1743-6109.2009.01283.x
26. 26.Weber AM, Walters MD, Piedmonte MR. Sexual function and vaginal anatomy in women before and after surgery for pelvic organ prolapse and urinary incontinence. Am J Obstet Gynecol. 2000;182(6):1610-1615. doi:10.1067/mob.[phone]
27. 27.Cholhan HJ, Hutchings TB, Rooney KE. Dyspareunia associated with paraurethral banding in the transobturator sling. Am J Obstet Gynecol. 2010;202(5):481.e1-481.e5. doi:10.1016/j.ajog.2010.01.061
28. 28.Narin R, Attar R, Narin MA, Koyuncu D, Yencilek E. Impact of transobturator tape procedure on female and their partner sexual function: it improves sexual function of couples. Arch Gynecol Obstet. 2014;290(5):913-917. doi:10.1007/s00404-014-3259-8
29. 29.Hsiao SM, Lin HH. Impact of the mid-urethral sling for stress urinary incontinence on female sexual function and their partners’ sexual activity. Taiwan J Obstet Gynecol. 2018;57(6):853- 857. doi:10.1016/j.tjog.2018.10.015
30. 30.Souders CP, Miranda AF, Sahor F, et al. Long-term outcomes and complications of trans-vaginal mesh removal: a 14-year experience. Urology. 2022;169:70-75. doi:10.1016/j.urology.2022.07.039
31. 31.Grisales T, Ackerman AL, Rogo-Gupta LJ, Kwan L, Raz S, Rodriguez LV. Improvement in dyspareunia after vaginal mesh removal measured by a validated questionnaire. Int Urogynecol J. 2021;32(11):2937-2946. doi:10.1007/s00192-021-04923-7