Female sexual function following a novel transobturator sling procedure without paraurethral dissection (modified-TOT)

• Published in: International Brazilian Journal of Urology Vol. 43; no. 1; pp. 142 - 149
• Main Authors: Arslan, Burak, Onuk, Ozkan, Eroglu, Ali, Gezmis, Tugrul Cem, Aydin, Memduh
• Format: Journal Article
• Language: English
• Published: Brazil Sociedade Brasileira de Urologia 01.01.2017
• Subjects: Adult; Aged; Cystoscopy - methods; Dyspareunia; Educational Status; Equipment Design; Female; Humans; Middle Aged; Needles; Original; Patient Satisfaction; Postoperative Period; Preoperative Period; Prospective Studies; Quality of Life; Severity of Illness Index; Sexual Dysfunction, Physiological - physiopathology; Sexual Dysfunction, Physiological - psychology; Sexuality - physiology; Sexuality - psychology; Statistics, Nonparametric; Suburethral Slings; Surveys and Questionnaires; Treatment Outcome; Urinary Incontinence, Stress; Urinary Incontinence, Stress - physiopathology; Urinary Incontinence, Stress - surgery; Urinary Incontinence, Stress; Dyspareunia; Suburethral Slings
• ISSN: 1677-5538; 1677-6119; 1677-6119; 1677-5538
• DOI: 10.1590/S1677-5538.IBJU.2016.0270

To determine whether there is a difference in sexual function after modified and classical TOT procedures. Of the 80 sexually active women with SUI, 36 underwent na original outside-in TOT as described by Delorme, and 44 underwent modified TOT procedure, between 2011 and 2015. The severity of incontinence and sexual function were evaluated using International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) and Female Sexual Function Index (FSFI) questionnaires preoperatively and 3 months after surgery. The postoperative ICIQ-SF score was significantly lower than the preoperative ICIQ-SF score in both groups (p=0.004 for modified TOT and p=0.002 for classical TOT). There was no significant difference in the ICIQ-SF score reduction between the two groups (14.1±2.1 vs. 14.4±1.9; p=0.892). Complication rates according to the Clavien-Dindo classification were also similar in both groups. In both groups, difference between preoperative and postoperative FSFI scores revealed a statistically significant improvement in all domains. Comparison of postoperative 3-month FSFI scores of modified and classical TOT groups showed statistically significant differences in arousal, lubrication and orgasm domains. Desire, satisfaction, pain and total FSFI scores did not differ significantly between two groups. The modified TOT technique is a simple, reliable and minimal invasive procedure. The cure rate of incontinence and complication rates are the same as those of the classical TOT technique. However, due to the positive effects of minimal tissue damage on sexual arousal and orgasmic function, modified TOT has an advantage over the classical TOT.