Urinary complications and sexual function after the tension-free vaginal tape procedure.

OBJECTIVE

The purpose of this prospective study was to evaluate urinary and sexual function after the tension-free vaginal tape (TVT) support procedure for stress urinary incontinence (SUI).

METHODS

Between January 1999 and July 2002 a total of 71 patients underwent comprehensive examination including urodynamics and a mailed self-administered questionnaire for assessment of voiding and sexual function before and after treatment of SUI by TVT.

RESULTS

Based on objective findings TVT was considered as curative in 48 patients (87.3%). Comparison of preoperative and postoperative urodynamic evidence demonstrated a significant outflow obstruction (<12 ml/s) in 19 patients (34.5%). A significant decrease in peak urinary flow during voiding (p < 0.001) was also observed. Of the 55 women (78.5%) who responded to the questionnaire before and after TVT, 42 (76.3%) reported satisfaction with the outcome. Postoperatively, 60% of patients reported voiding difficulty, 47.2% complained of urgency, and 32.7% of frequency. Regarding sexual function 20% reported impairment after surgery including dyspareunia in 14.5% (none preoperatively vs. eight postoperatively, <0.01) and loss of libido in 5.4%.

CONCLUSION

The TVT procedure is an effective treatment for SUI. However, it can lead to postoperative voiding and sexual impairment.