Sexual Function and Discomfort in Women After Midurethral Sling Surgery

The purpose of this study was to evaluate medium-term sexual function following midurethral sling (MUS) surgery.

This was an ambidirectional observational study with a nested matched case–control study performed in a tertiary urogynecology referral center. We assessed sexual discomfort and function using the Pelvi-Perineal Surgery Sexuality Questionnaire (PPSSQ), pre- and postoperatively, in a patient cohort that comprised patients who underwent an MUS procedure between January 2014 and December 2019. We recruited a group of volunteers without a previous history of MUS surgery. The nested case–control study comprised a subgroup of cases from the patients’ cohort matched to controls from the volunteer’s cohort. Cases and controls were matched for age and menopausal status at a 1:1 ratio.

A total of 118 patients and 128 volunteers were recruited. Of these, 105 cases and 105 controls comprised the nested case–control study. There was no statistically significant difference in the mean discomfort and pain scores between cases and controls (19.8 ± 21.2 vs 15.4 ± 15.7 respectively; p = 0.19 primary outcome). Similarly, there was no difference in mean sexual health scores. However, the rate of reported sensation of an obstruction in the vagina was significantly more in cases (16%) than in controls (2.6%; p = 0.001). There were no significant differences between patient-reported sexual function at follow-up compared with their recollection before surgery.

Midurethral sling surgery does not seem to impair the quality of sexual life in the medium term.