Sexual function after vaginal surgery for stress incontinence: Results of a mailed questionnaire

Objectives. To address the issue of sexual dysfunction after vaginal surger y for incontinence based on responses to a mailed questionnaire. Methods. A sexual function questionnaire was mailed to 93 women who underwe nt anterior vaginal wall suspension for stress urinary incontinence alone ( group 1) or in conjunction with a concomitant posterior repair (group 2) at least 1 year previously. Results. A total of 56 (60%) women responded. Following surgery, 10 (37%) w omen in group 1 reported themselves as sexually active and 12 (41%) in grou p 2, which was similar to preoperative values. Only woman in group 1 and 3 women in group 2 attributed their sexual inactivity to their own lack of de sire or inability to have intercourse. Overall, 20% of women noted pain dur ing intercourse, a finding slightly lower than the preoperative incidence ( 29%). No difference in the incidence of dyspareunia was noted between group s. Still, several women (18%) reported intercourse to be worse following su rgery. Women who were either premenopausal or on hormone replacement therap y were more likely to be sexually active following surgery (46%) than those not on hormone replacement (17%). Conclusions. Overall, the percentage of women who were sexually active did not appear to be affected by a vaginal suspension procedure for incontinenc e. Symptomatic vaginal narrowing was rare, even among women undergoing simu ltaneous posterior repair. Still, nearly 20% of women considered intercours e to be worse postoperatively, although not all women reported dyspareunia. The possible causes for postoperative sexual dysfunction require further i nvestigation. UROLOGY 56: 223-227, 2000. (C) 2000, Elsevier Science Inc.