Evaluating the impact of mid-urethral sling surgery and bulk injection therapy on sexual function in women with stress urinary incontinence.

This study evaluated the impact of mid-urethral sling (MUS) surgery and bulk injection (BI) therapy on sexual function in women with stress urinary incontinence (SUI). The study found that BI therapy and MUS surgery improved sexual function equally in sexually active women with SUI.

Stress urinary incontinence (SUI) is the involuntary leakage of urine when there is pressure (stress) on the bladder due to physical activity such as coughing, sneezing, running, or heavy lifting. It can affect 4-35% of women and negatively affects the quality of life of the patients.

SUI can be treated in different ways. One treatment involves injecting a bulking agent into the urethra (where urine passes through from the bladder). The bulking agent thickens the walls of the urethra, narrowing the opening of the tube and reducing urine leakage. Bulk injection (BI) therapy with Polydimethylsiloxane Urolastic (PDMS-U; Urogyn) is commonly used in the treatment of SUI. PDMS-U is one of the most recent bulking agents which consists of a smooth material that is not absorbed by the body.

Another treatment involves surgery to reduce urine leakage. MUS is a common surgical treatment option for patients with SUI. The MUS provides support for the urethra and lowers the chance of SUI occurring again. However, the impact of MUS surgery and BI therapy using PDMS-U on sexual function in patients with SUI is still unknown.  

This study involved 259 women with SUI. 146 patients were treated with MUS surgery. 113 women were treated with BI therapy with PDMS-U. A questionnaire was used to assess the patients’ sexual function at the start of the study, at 6 months, and at 12 months of treatment.

After 12 months, the questionnaire score improved for both treatment groups. The questionnaire score at 6 and 12 months was similar for both treatment groups.

This study concluded that bulk injection therapy using PMDS-U and MUS surgery improved sexual function equally in sexually active women with SUI.

The patients were not randomly assigned to the treatment groups. This study did not evaluate the impact of other bulking agents.