Does depression impact treatment outcomes of vaginal sling procedures?

This study examined the link between depression and treatment outcomes of vaginal sling procedures. Researchers reported greater improvements in urinary incontinence symptoms, quality of life, and sexual function after surgery in women with depression.

Vaginal sling procedures are currently the most common type of surgery used to help control urinary incontinence (UI). Identifying risk factors that could affect quality of life or treatment outcomes after surgery are important for determining long-term prognoses. Previous reports indicate that depression can significantly impact the treatment outcomes of a number of major surgeries. The presence of depression has also been associated with worse UI symptoms and lower quality of life in patients with UI. Whether depression affects outcomes of a vaginal sling procedure is poorly understood at this time.

The aim of this study was to examine the link between depression and treatment outcomes of vaginal sling procedures.

The results of a trial comparing two types of vaginal sling procedures were analyzed. 526 women with UI were randomly assigned to undergo either tension-free vaginal tape surgery or vaginal tape-obturator surgery. 15% of women had depression before treatment. Treatment outcomes were followed for 12 months.

Women with depression had worse UI symptoms before surgery compared to those without depression. Quality of life and sexual function before treatment were also worse in depressed women than in non-depressed women.

Depressed women showed greater improvements in UI symptoms after surgery compared to non-depressed women. UI symptoms at 12 months were similar between the two groups. Women with depression were also associated with greater improvements in sexual function and quality of life. However, sexual function was still lower than those of non-depressed women after surgery. At 12 months, 83% of those with depression prior to surgery were no longer depressed.

Researchers concluded that women with depression improve significantly more following a vaginal sling procedure than women without depression. 

A questionnaire was used to measure depression. This is often not as reliable as a clinical diagnosis of depression by a physician.