Sexual function and single incision sling: functional outcomes and ultrasound insight after surgery for stress urinary incontinence.

BACKGROUND

Stress Urinary Incontinence (SUI) significantly impacts female Sexual Function. Single Incision Mini-Sling (SIMS) has emerged as a less invasive therapeutic option than Traditional Trans-Obturator (TOT) and retropubic (TVT) slings, however its effects on functional outcomes and the anatomical factors influencing sexual function remain incompletely understood.

OBJECTIVE

To evaluate the impact of SIMS on female sexual function at 6 months post-surgery and identify ultrasound parameters correlated with functional improvement.

METHODS

A retrospective cohort study of 36 sexually active patients undergoing SIMS for SUI is presented. Twenty-three patients completed 6-month follow-up evaluation using validated questionnaires: Female Sexual Function Index (FSFI), Female Sexual Distress Scale (FSDS), and International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF). Pelvic floor ultrasound assessed anatomical parameters including bladder neck-sling distance, pubic symphysis-sling distance and the angle between the branches of the sling. Statistical analysis included parametric, non-parametric tests, and Spearman correlations.

RESULTS

Significant improvement in sexual function was observed post-operatively. FSFI scores increased from 23.3 ± 4.2 to 26.7 ± 2.7 (p = 0.0036), while FSDS scores decreased from 33.5 ± 12.9 to 12.1 ± 14.0 (p < 0.001). These improvements were independent of baseline dysfunction status. Correlation analysis revealed significant associations with specific ultrasonographic parameters: bladder neck-sling distance and pubic symphysis-sling distance are correlated with FSDS improvement (ρ = 0.417, p = 0.042 and ρ = -0.447, p = 0.028, respectively), and sling branch angle strongly correlated with FSFI improvement (ρ = 0.668, p = 0.0005).

CONCLUSIONS

SIMS significantly improves sexual function scores (FSFI and FSDS) at 6 months post-surgery, with benefits independent of baseline sexual dysfunction status. Specific anatomical parameters may modulate therapeutic response, suggesting the importance of optimized sling positioning to maximize functional benefits.