Erosion after suburethral sling insertion for stress incontinence

Introduction

The impact on the sexual function of treated women has received little attention in the medical literature. Due to the site of insertion of the permanent TVT the tape might interfere with arousal and sensory stimulation during intercourse. Recent studies have reported varying degrees of sexual impairment after TVT insertion ranging from 0–15% including dyspareunia.

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 was assesed.

Patients and Methods

Between December 2005 and December 2007, we included 18 female patients who complained of de-novo dyspareunia after suburethral sling insertion. All patients filled in an FSFI questionnaire prior to sling removal and at three 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.

Results

Of the 18 slings, ten were transobturator tapes (6xTVT-O, 2xMonarch, 2x unknown) and eight were retropubic tapes (7xTVT, 1x SPARC) Statistically desire, arousal, lubrication, satisfaction and pain improved significantly. Orgasm scores were low with median scoring of 1.5 scores before and 1.0 scores after sling removal and did not change significantly after sling removal. The satisfaction rate deteriorated from a median of 7 (95% CI 6.3 to 7.7) to a median of 4 (95%CI3.7–5.1; p=0.99) but not statistically significant.

Conclusion

Sexual functions in patients with de-novo dyspareunia is likely to improve after sling removal but not in all domains. The bladder function may deteriorate.