Van Isacker Marie, Van der Aa Frank
Department of Urology, University Hospitals Leuven, Louvain, Belgium.
Int Urogynecol J. 2025 Feb 6. doi: 10.1007/s00192-025-06058-5.
Stress urinary incontinence (SUI) is a common condition among women of childbearing age, often requiring surgical intervention. The midurethral sling (MUS), including first-generation tension-free vaginal tapes (TVT) and second-generation transobturator tapes (TOT, TVT-O), has long been the standard treatment. However, both approaches have associated risks, prompting the development of single-incision slings (SIS) as a third option. SIS have proven their efficacy in SUI treatment, but the impact of these slings on female sexual function specifically remains underexplored.
A literature search was conducted using PubMed using the keywords "stress urinary incontinence," "midurethral slings," "single-incision slings," "female sexual function," and "dyspareunia."
The reviewed studies demonstrated that SIS generally maintain or improve sexual function postoperatively, but with varying impact on specific aspects of sexual function. While coital urinary incontinence often improved or resolved, new or worsened dyspareunia was reported in a significant number of patients.
SIS placement for SUI generally preserves or enhances sexual function, though individual aspects, such as dyspareunia, may worsen for some patients. Given that an important goal of SUI treatment is to improve quality of life, it is crucial to identify preoperative factors that will identify patients at risk of developing dyspareunia after surgery or are more likely to experience an improvement in sexual function. Further research is needed to better understand these predictors and optimize surgical outcomes for women undergoing SUI treatment with SIS.
压力性尿失禁(SUI)在育龄女性中很常见,常需手术干预。中段尿道吊带术(MUS),包括第一代无张力阴道吊带术(TVT)和第二代经闭孔吊带术(TOT、TVT - O),长期以来一直是标准治疗方法。然而,这两种方法都有相关风险,促使单切口吊带术(SIS)作为第三种选择得以发展。SIS已在SUI治疗中证明了其有效性,但这些吊带对女性性功能的具体影响仍未得到充分研究。
使用PubMed进行文献检索,关键词为“压力性尿失禁”“中段尿道吊带术”“单切口吊带术”“女性性功能”和“性交困难”。
综述研究表明,SIS术后一般能维持或改善性功能,但对性功能的具体方面影响各异。虽然性交性尿失禁通常有所改善或得到解决,但相当数量的患者报告出现了新的或加重的性交困难。
SIS用于治疗SUI一般能保留或增强性功能,不过某些个体方面,如性交困难,可能会在部分患者中恶化。鉴于SUI治疗的一个重要目标是提高生活质量,识别术前因素以确定术后有发生性交困难风险或更可能性功能改善的患者至关重要。需要进一步研究以更好地理解这些预测因素,并优化接受SIS治疗SUI的女性的手术效果。