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Sexual Function Following TVTO Placement: Minimum 12 Month Follow Up
Ashley B King1, Jeffrey P. Wolters1, Adam P. Klausner1, David E. Rapp2
1Virginia Commonwealth University, Richmond, VA;2Virginia Urology Center for Incontinence and Pelvic Floor Reconstruction, Richmond, VA

Introduction: The effect of anti-incontinence surgery on sexual function is not clear based on the current literature. The study aim was to examine the impact of TVTO on sexual function and vaginal symptoms.
Methods: This study is a retrospective review of thirty-three undergoing TVTO with a minimum of 12 month follow-up. Outcomes were assessed using validated questionnaires, with focus on the International Consultation on Incontinence Questionnaire-Vaginal Symptoms (ICIQ-VS). The ICIQ-VS is a validated measure assessing impact of vaginal symptoms and associated sexual matters on quality of life and treatment outcome. Incontinence impact questionnaire (IIQ-7) was used a secondary measure of quality of life. Quality of life scores were also compared to patient perceived level of improvement.
Results: Mean age was 61.8 years old (+13.6) with average parity of 2.1 children (+1.2). Improvements in ICIQ vaginal symptom (6.7 to 3.8, p<0.01), sexual function (4.1 to 2.7, p=0.13), and quality of life scores (3.2 to 1.6, p<0.01) were seen in comparison of baseline and 12-month questionnaire evaluations. VS QOL scores demonstrate score improvement, stability, and deterioration in 14, 14, and 5 patients, respectively. Pearson's correlation of QOL outcomes and patient perceived level of improvement demonstrated weak correlations (VS-QOL versus improvement (r=-0.37), IIQ versus improvement (r=0.36), p<0.05, both comparisons).
Conclusions: Anti-incontinence surgery is associated with improvements in validated measures of sexual function and vaginal symptoms. The vast majority of patients reported symptom stability or improvement in these endpoints. Vaginal symptom QOL outcomes and patient perceived improvement were weakly correlated.


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