Quality Of Life And Sexual Function In Women Before And After Transobturator Tape(TOT)Procedure For Stress Urinary Incontinence

Objective To evaluate quality of life and sexual function in women before and after Trans-obturator tension-free tape operation for stress urinary incontinence. Method The present prospective study included 91 cases of women with SUI and no concomitant prolapse who underwent a TOT procedure. the Incontinence Quality of Life(I-QOL) questionnaire was sent to 91 patients who underwent TOT surgery before and at 3 months 、6months 、12months after the operation.The higher I-QOL score indicated better quality of life. Before and at 3months、6 months、12months after surgery,Pelvic organ prolapse urinary incontinence sexual function questionnaire-12( P ISQ-12) was sent to 59 sexually active patients who underwent Transobturator tension-free tape(TOT). The higher PISQ-12 score indicated better quality of sexual life. The patient was divided into two groups according to whether there was concomitant coital incontinence before the operations. For the groups,we compared the rate of PISQ-12 score improvement. We also investigate the patient’s general condition, operation time, blood loss, complications, and the subjective effects of surgery.All descriptive date are reported as mean ± standard deviation(SD).All qualitative date are reported as n(%).A paired t test was used to compare the pre- and postoperative questionnaire scores. The Wilcoxon test(non-parametric test) was used to compare the pre- and postoperative questionnaire scores. The chi-square test was used to compare the rate of PISQ-12 score improvement. The statistical analyses were performed with SPSS version 17.0(SPSS,Chicago, IL, USA). P<0.05 was considered to be statistically significant. Result Among the 91 patients there was significant change in the total score of IQOL after surgery(P<0.05),while the Behavior constraints, social psychology, social embarrassment factor scores were significant increased after surgery(P<0.01). The Behavior constraints score, social psychology score and I-QOL score was decreased at 12 months after surgery compared with the 6 months after surgery, but without statistical significance(P>0.05). Among the 59 patients followed up at 3 months after surgery,the total score of PISQ-12 and emotional factor score were significantly decreased after surgery(P<0.05),while there was no significant change in the sexual partner factor score after surgery(P>0.05). Among the 59 patients followed up 6 months after surgery,there was no significant change in the total score of PISQ-12、 emotional factor score and sexual partner factor score after surgery(P>0.05),while there was significant change in the physiological factor score after surgery(P<0.05). The same results at 12 months as followed up 6 months after surgery. The total score of PISQ-12 in 21(77.8%)of the 27 patients with involuntary urine leakage in sexual life before surgery was increased after surgery,that in 5(15.6%)of the 32 patients without involuntary urine leakage in sexual life before surgery was increased after surgery, and there were significant differences in the rates of improvement in quality of sexual life between them(P<0.05). Conclusion TOT procedure can improve the patient’s quality of life.It does not have consistent negative effects on sexual life of patients.There may be negative effect on sexual life of patients within 3 months after surgery, but it may gradually disappear later.The quality of sexual life of patients with involuntary urine leakage during sexual life before surgery may be improved after surgery due to the symptom alleviation.