. 2015 Sep 14;1:6. doi: 10.1186/s40695-015-0007-6

Table 3.

Effect of surgical treatments of stress urinary incontinence on sexual function

Study	Design	N	Treatment	Length of Follow Up (months)	Instrument	Findings				Coital Incontinence
Study	Design	N	Treatment	Length of Follow Up (months)	Instrument	Overall Post-Operative Sexual Function	Improved	Worsened	No Difference	Coital Incontinence
Midurethral sling: Retropubic (TVT)
Jha et al [62]	Prospective case series	62	TVT	3	ePAQ	N/A	• Impact of LUTS on sex (p < 0.001)	N/A	• Partner avoidance of sex (p = 0.06)	• Improved (p < 0.001)
							• Avoidance of sex (p < 0.001)
							• Anxiety of UI & sex (p < 0.001)
Ghezzi et al [70]	Prospective case series	53	TVT	6-12	PISQ	• Improved: 34 %	N/A	N/A	• Fear of incontinence	• Improved in 87 %, with associated improvement:
						• Worsened: 3.8 %			• Frequency	• Frequency
										• Fear of CI
										• Embarrassment
Midurethral sling: Retropubic (TVT) versus Transobterator (TVT-O, TOT) comparative studies
Elzevier et al [71]	Prospective cohort	1. TVT-O: 34	1. TVT-O	3-4	Lemack	• Improved: 20.6 & 18.2 % (TVT, TVT-O respectively)	N/A	• Dyspareunia from vaginal narrowing in TOT [vs TVT-O] (p = 0.026)	• Frequency	• Improved
		2. TOT: 44	2. TOT			• Worsened: 5.9 & 18.2 % (TVT, TVT-O respectively			• Lubrication loss (p = 0.612)
		2. TOT: 44	2. TOT			• Worsened: 5.9 & 18.2 % (TVT, TVT-O respectively			• Clitoral lumescence reduction, sensibility (p = 0.191, p = 0.346 respectively)
Jha et al [64]	Prospective cohort	1. TVT: 43	1. TVT	6	PISQ	N/A	• Total PISQ (p < 0.001)	N/A	• Behavior emotive subdomain (p = 0.7)	• Improved (p < 0.002)
Jha et al [64]	Prospective cohort	2. TVT-O: 11	2. TVT-O				• Partner, Physical subdomains (p = 0.002, p < 0.001 respectively)	N/A	• Behavior emotive subdomain (p = 0.7)	• Improved (p < 0.002)
Zyczynski et al [67]	RCT	1. TVT: 298	1. TVT	24	PISQ	N/A	• Total PISQ (p < 0.0001)	• PISQ in surgical failure [vs success] (p = 0.009)	• PISQ between TVT & TOT	• Improved (p < 0.0001)
		2. TOT: 299	2. TOT				• Pain (p = 0.003)		• Proportion of sexually active patients post-op
		2. TOT: 299	2. TOT				• Fear of UI & sex (p < 0.0001)		• Proportion of sexually active patients post-op
Filocamo et al [61]	Prospective cohort	1. TVT: 28	1. TVT	12	FSFI	N/A	• Total FSFI (p < 0.002)	N/A	• FSFI between TVT & TOT	N/A
		2. TOT: 105	2. TOT				• All subdomains (p < 0.002)
		2. TOT: 105	2. TOT				• Sexual dysfunction (P = 0.05)
Cayan et al [75]	Prospective cohort	1. TVT or vaginal repair: 53	1. TVT or vaginal repair	1. Sling: 32.1 +/- 13.7	FSFI	• Improved: 24.5 & 12.2 % (TVT, Burch respectively)	N/A	• Total FSFI (p < 0.001)	• Pain (p = 0.162)	N/A
		2. Burch: 41	2. Burch	2. Burch: 35.7 +/- 16.7		• Worsened: 47.2 & 63.4 % (TVT, Burch respectively)		• Desire, arousal, lubrication, orgasm, satisfaction subdomains (p ≤ 0.002)
		2. Burch: 41	2. Burch	2. Burch: 35.7 +/- 16.7		• Worsened: 47.2 & 63.4 % (TVT, Burch respectively)		• Total FSFI, desire, arousal, lubrication, orgasm in Burch [vs TVT] (p = 0.004-0.026)
Periurethral bulking injection
Leone Roberti Maggiore et al [76]	Prospective case series	29	Polyacrylamide hydrogel periurethral injection	12	PISQ, Global sexual satisfaction VAS score	N/A	• Total PISQ (p < 0.001)	• Global sex satisfaction in surgical failure [vs success] (p < 0.001)	• Pain (p = 0.244)	• Improved (p < 0.001)
							• Desire, orgasm frequency, excitation, satisfaction, fear of UI & sex, negative emotional reaction, orgasm intensity (p < 0.001)
							• Global sex satisfaction VAS score (p < 0.001)

CI Coital incontinence; ePAQ Electronic Pelvic Floor Symptoms Assessment Questionnaire; FSFI Female sexual function index; PISQ Pelvic Organ Prolapse-Urinary Incontinence Sexual Function Questionnaire; RCT Randomized controlled trial; SA Sexually active; TVT Tension-free vaginal tape; TVT-O Tension-free vaginal tape - obturator; TOT transobturator tape; VAS visual analog scale