Sexual Function Improvement Following Surgery for Stress Incontinence: The Relevance of Coital Incontinence


Milou Bekker, MD, Department of Urology, Leiden University Medical Centre, PO Box 9600, Leiden 2300 RC, The Netherlands. Tel: 0031-71-5265260; Fax: 0031-71-5248135; E-mail:


Introduction.  Little is known about the impact of surgery for stress urinary incontinence (SUI) on female sexual function, and results are conflicting.

Aims.  We aimed to clarify the impact of surgery for SUI on female sexual function.

Methods.  We analyzed data collected from two studies evaluating sexual function in women after placement of the tension-free vaginal tape, tension-free vaginal tape obturator, or transobturator suburethral tape. A nonvalidated sexual questionnaire developed by Lemack, translated into Dutch, was mailed to all patients 3–12 months after the procedure.

Main Outcome Measures.  Pre- and postoperative results of a nonvalidated sexual questionnaire.

Results.  A total of 136 sexually active women completed the questionnaires. Compared with preoperative responses, we observed no significant changes postsurgical regarding frequency of sexual intercourse or satisfaction of sexual intercourse, although a significant postoperative decrease in urinary coital incontinence (P ≤ 0.001) was found. Postoperatively, 29 women (21.3%) reported improved sexual intercourse, and eight women (5.9%) complained of a worsening. There was a significant higher rate of preoperative coital incontinence (86.2% women with coital incontinence) in the group of women who reported improved intercourse (P = 0.01).

Conclusion.  Women with coital incontinence show a significant higher improvement in sexual function after surgery for SUI compared to women without coital incontinence. Our results suggest that improvement in coital incontinence results in improvement of sexual function. Therefore, coital incontinence is a prognostic factor for improvement of sexual function following incontinence surgery. Bekker M, Beck J, Putter H, Venema P, Lycklama à Nijeholt A, Pelger R, and Elzevier H. Sexual function improvement following surgery for stress incontinence: The relevance of coital incontinence. J Sex Med 2009;6:3208–3213.