The effect of tension-free vaginal tape on coital incontinence concomitant with stress urinary incontinence.

OBJECTIVES: The aim of this study was to evaluate the impact of tension-free vaginal tape (TVT) on coital incontinence concomitant with stress urinary incontinence. METHODS: TVT was performed on sexually active women diagnosed with urodynamic stress incontinence (USI) who also experienced coital incontinence with penetration and/or orgasm. The patient-reported success rate was assessed by the Patient's Global Impression of Improvement (PGI-I) scale. The sexual function of the women was evaluated by the fulfilled Female Sexual Function Index (FSFI) before and after the operations. RESULTS: Eighty-two women underwent the TVT procedure with epidural anesthesia and 80 of them (97%) answered pre-operative and post-operative FSFI questionnaires. In the pre-operative clinical assessment, 48 women (58%) stated they experienced urinary incontinence during penetration, 13 (15%) during orgasm, and 21 (25%) identified it for both. The patient-reported success rate was 86% (71 of 82 patients) according to the PGI-I results: 44 of 48 women (91%) during penetration, nine of 13 (69%) during orgasm, and 18 of 21 (85%) for both. The FSFI scores for sexual desire, lubrication, and sexual arousal domains increased in 57 (71%), 49 (61%), and 44 (55%) patients, respectively, whereas they remained unchanged in 23 (28%), 31 (38%), and 36 (45%) patients. For the orgasm, satisfaction, and pain domains, the results were similar. The mean total FSFI score before the operations was 23.63 ± 6.84 and it significantly increased after surgery to 29.47 ± 4.28 (P < .05). CONCLUSIONS: The TVT procedure may offer treatment for coital incontinence accompanying USI. It also provides significant improvement in the sexual lives of women.