ABSTRACT
ABSTRACT Purpose To determine whether there is a difference in sexual function after modified and classical TOT procedures. Materials and Methods Of the 80 sexually active women with SUI, 36 underwent an 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. Results 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. Conclusion 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.
Subject(s)
Humans , Female , Adult , Aged , Sexual Dysfunction, Physiological/physiopathology , Urinary Incontinence, Stress/surgery , Urinary Incontinence, Stress/physiopathology , Sexuality/physiology , Suburethral Slings , Postoperative Period , Quality of Life , Sexual Dysfunction, Physiological/psychology , Severity of Illness Index , Prospective Studies , Surveys and Questionnaires , Treatment Outcome , Patient Satisfaction , Statistics, Nonparametric , Sexuality/psychology , Cystoscopy/methods , Educational Status , Equipment Design , Preoperative Period , Middle Aged , NeedlesABSTRACT
PURPOSE: To determine whether there is a difference in sexual function after modified and classical TOT procedures. MATERIALS AND METHODS: 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. RESULTS: 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. CONCLUSION: 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.
Subject(s)
Sexual Dysfunction, Physiological/physiopathology , Sexuality/physiology , Suburethral Slings , Urinary Incontinence, Stress/physiopathology , Urinary Incontinence, Stress/surgery , Adult , Aged , Cystoscopy/methods , Educational Status , Equipment Design , Female , Humans , Middle Aged , Needles , Patient Satisfaction , Postoperative Period , Preoperative Period , Prospective Studies , Quality of Life , Severity of Illness Index , Sexual Dysfunction, Physiological/psychology , Sexuality/psychology , Statistics, Nonparametric , Surveys and Questionnaires , Treatment OutcomeABSTRACT
INTRODUCTION: Penile prostheses are subject to a continuous development and have gained better mechanical reliability and safety during the last decades. In this study, we aimed to investigate the outcomes and satisfaction rates of inflatable penile prosthesis (IPP) and semirigid penile prosthesis (SPP) implantation. MATERIALS AND METHODS: From August 2001 to June 2012, 257 men with erectile dysfunction (ED) underwent penile prosthesis implantation (PPI) at our institution. Of the 257 patients, 118 underwent implantation of IPP and 139 underwent SPP implantation. The pre-operative and post-operative erectile status of the patients were assessed by international index of erectile function (IIEF) questionnaire. The satisfaction of patients and partners were evaluated by a telephone interview using the erectile dysfunction inventory of treatment satisfaction (EDITS) questionnaire and EDITS partner survey. RESULTS: The overall major complication rate was higher in IPP group. PPI led to a significant improvement in IIEF scores in both groups. For IPP and SPP groups the average EDITS scores were 78±11and 57±8, respectively, and that for the partners were 72±10 and 49±7, respectively (p<0.05). CONCLUSION: Although the IPP implantation have better satisfaction rates, the SPP implantation is still a viable treatment option in the surgical treatment of ED because of low cost and high durability with acceptable satisfaction rates.
Subject(s)
Erectile Dysfunction/surgery , Patient Satisfaction/statistics & numerical data , Penile Implantation/methods , Penile Prosthesis , Adult , Aged , Erectile Dysfunction/physiopathology , Humans , Male , Middle Aged , Penile Prosthesis/adverse effects , Postoperative Complications , Prosthesis Design , Retrospective Studies , Sexual Partners , Statistics, Nonparametric , Surveys and Questionnaires , Treatment OutcomeABSTRACT
Penile prostheses are subject to a continuous development and have gained better mechanical reliability and safety during the last decades. In this study, we aimed to investigate the outcomes and satisfaction rates of inflatable penile prosthesis (IPP) and semirigid penile prosthesis (SPP) implantation.
From August 2001 to June 2012, 257 men with erectile dysfunction (ED) underwent penile prosthesis implantation (PPI) at our institution. Of the 257 patients, 118 underwent implantation of IPP and 139 underwent SPP implantation. The pre-operative and post-operative erectile status of the patients were assessed by international index of erectile function (IIEF) questionnaire. The satisfaction of patients and partners were evaluated by a telephone interview using the erectile dysfunction inventory of treatment satisfaction (EDITS) questionnaire and EDITS partner survey.
The overall major complication rate was higher in IPP group. PPI led to a significant improvement in IIEF scores in both groups. For IPP and SPP groups the average EDITS scores were 78±11and 57±8, respectively, and that for the partners were 72±10 and 49±7, respectively (p<0.05).
Although the IPP implantation have better satisfaction rates, the SPP implantation is still a viable treatment option in the surgical treatment of ED because of low cost and high durability with acceptable satisfaction rates.