A recent Italian study has shown that there is significant improvement to female sexuality following successful treatment of incontinence with a mid-urethral sling (MUS). Whereas prior studies emphasised the complications of such an approach, and the resulting diminished sexuality, this new data shows that the opposite may be true.

During her poster presentation “Sexual activity before and after mid-urethral sling: a prospective multicentre study,” Prof. Elisabetta Costantini (Italy) explained that gauging the patient’s sexual activity plays a key role.

“The multicentre study was based on 133 patients in a five-year period. It was decided to use the Female Sexual Function Index (FSFI) questionnaire to gauge patients’ sexuality before and after surgery,” she said.

“Female sexuality is a complex issue, and this is particularly true when we operated on these women. I wanted to understand how many women were active before the surgery, and how many then became inactive, and vice-versa. This topic is not clear in urological studies: prior studies only involved sexually active women,” Constantini explained,

Because these prior cases often looked at the sexually active women, and their subsequently diminished sexual activity, the group that went from no sexual activity to a large improvement was not included. In the latter cases, the mid-urethral sling actually improved sexual function, leading to an increase from 59% to 71% of patients being sexually active before and after treatment for incontinence, respectively.

Reflecting on the way forward for this research, Costantini commented: “We need to put women, and what they want, central. Some women are simply not interested in a sexual life, and we have to take that into account. Not enough urologists ask their patients before the MUS if they are sexually active.”

As co-chair of Poster Session 5 (Sexual functions and quality of life in functional urology), Costantini has first-hand experience in participating in the format that gained more emphasis at this year’s congress. “I was curious to see how the new format would play out in practice. I noticed that while standing near the posters, the atmosphere is less formal and people interact more readily with the poster presenter. In this particular session, there was less interaction during the extended poster presentations, but we will see how this improves from session to session.”

By Loek Keizer