The Effect Of TOT Combined With Vaginal Reconstruction On Sexual Function In Patients With Stress Urinary Incontinence And Vaginal Laxity Syndrome

Objective(s):To investigate the effect of trans obturator tension-free tape(TOT)combined with vaginal reconstruction on sexual function with stress urinary incontinence(SUI)and vaginal laxity syndrome(VLS).Methods:From January 1,2021 to December 30,2022,the clinical data of patients with SUI complicated with VLS and sexual intercourse more than 3 times per month who were hospitalized in this institution were collected.Conduct patient complaints and questionnaire surveys before and 6 and 12 months after treatment.Preoperative and postoperative sexual function assessments were conducted on the participants before treatment and 6 and 12 months after treatment through patient complaints and questionnaire surveys,as well as a simplified version of the pelvic organ prolapse and urinary incontinence sexual function questionnaire.Is there a difference in the impact of different surgical methods on sexual function in patients with moderate SUI combined with VLS.Results:1.There were 103 patients with moderate SUI,including 90 patients with VLS,77 meeting the inclusion criteria,2 patients underwent removal due to sling erosion after surgery,and 3 patients were lost to follow-up.A total of 72 patients with moderate SUI combined with VLS were included in the study and completed 12-month follow-up,including 55 patients(group A)who received TOT combined with vaginal reconstruction,and 17 patients(group B)who received TOT.2.(1)Preoperative evaluation:There was no statistical significance in age,Body Mass Index(BMI),I-QOL,PISQ-12 and other aspects between group A and Group B before surgery(P>0.05).(2)Quality of life assessment:The I-QOL score of group A was significantly higher at 6 months after surgery(81.63±1.60)and 12 months after surgery(84.02± 1.21)than that before surgery(36.05±4.52),and the quality of life was significantly improved.The I-QOL score of group B was significantly increased at 6 months(82.42± 1.14)and 12 months after surgery(83.82.02± 1.24)compared with that before surgery(36.02±3.28),and the quality of life was significantly improved.Six months after operation,the life quality score of group B(82.42±1.14)was slightly higher than that of group A(81.63±1.60).With the increase of time,12 months after surgery,the life quality score of group A(84.02± 1.21)was higher than that of group B(83.82±1.24).(3)Evaluation of sexual life quality:PISQ-12 scores of group A at 6 months after surgery(27.05±3.78)and 12 months after surgery(34.84±3.27)were higher than those before surgery(25.65±4.11),and sexual life quality was significantly improved.The PISQ-12 scores of Group B at 6 months after surgery(30.53±2.71)and 12 months after surgery(31.18±2.81)were higher than those before surgery(24.62±4.69),and the sex life quality was significantly improved.However,six months after surgery,PISQ-12 score of group A was significantly lower than that of group B.As time went by,PISQ-12 score of group A was significantly higher than that of group B at 12 months after surgery.Conclusion(s):Clinically,it is not uncommon for SUI patients to be complicated with VLS.TOT improves sexual life quality mainly to solve the negative effects caused by coital incontinence,and the I-QOL and PISQ-12 scores did not increase significantly 6 months after surgery.In addition,TOT combined with vaginal reconstruction for treatment of SUI strengthens the pelvic floor muscles and constricts the vagina,so that the patient’s sexual function can be improved for a longer time.