BERKELEY, CA (UroToday Inc.) - Urinary incontinence can significantly impact quality of life (QOL). Surgical treatment improves this QOL. The effect of continence surgery on women's subsequent sexual function has been poorly studied, however. Therefore, R. G. Rogers and colleagues performed a prospective multicenter trial to evaluate sexual function after continence surgery.

Subjects were participating in a randomized trial at four centers in the United States. The trial purpose involved evaluation of the use of antibiotic prophylaxis against urinary tract infection after continence surgery. Sexual function and incontinence were assessed also using the self administered 31 question Pelvic Organ Prolapse Urinary Incontinence Sexual Questionnaire (PISQ) and the 7 question Incontinence Impact Questionnaire short form (IIQ-7). They evaluated those who qualified for the larger study and were willing also to complete the questionnaires before surgery, and at 3 and 6 months after surgery.

Their results were reported in the July 2004 edition of the American Journal of Obstetrics and Gynecology. One hundred two women initially agreed to participate, but 27 women did not complete all the data, leaving 75 women who finished all questionnaires. Twenty nine percent of women had a postoperative improvement in PISQ scores, while 71% had a decrease in PISQ score, indicating that the majority had an overall deterioration in sexual function. IIQ-7 scores decreased postoperatively reflecting a decreased (and therefore improved) impact of incontinence on social functioning. The most significant decrease in PISQ scores was seen in those patients undergoing concomitant prolapse surgery.

Overall, sexual function as measured by the PISQ declined after continence surgery in the majority of patients. Although the long-term effects of continence surgery on sexual function were not addressed in this study, this gives the surgeon important information which he/she can use to counsel patients regarding the potential perioperative morbidity associated with continence surgery.

Am J Obstet Gynecol 2004; 191:206-210