The Effect of the Distance Between Mesh and the Urethra on Sexuality in Patients Who Underwent Transobturator Tape.
Condition: Urinary Incontinence; Sexual Dysfunction; Ultrasonography
MeSH terms: Urinary Incontinence
Study type: Observational [Patient Registry]

Summary: 
      Urinary incontinence, commonly observed among women aged 30 to 60, encompasses Stress Urinary
      Incontinence (SUI), responsible for the majority of cases. This condition significantly
      affects the quality of life, influencing physical, emotional, and sexual aspects. Severe
      cases impact libido and cause vaginal dryness, affecting not just sexual function but also
      relationships, leading to an overall decline in quality of life. Hence, examining sexual
      functions in those affected by SUI holds significance.

      The study aimed to evaluate the impact of mesh-urethra distance on sexual functions using
      perineal ultrasound in continent patients post-transobturator tape (TOT) surgery for isolated
      SUI.

      Patients achieving continence post-surgery were categorized based on the distance from the
      posterior of the urethra at the bladder neck to the nearest proximal edge of the tape: < 5 mm
      and > 5 mm.

      Questionnaires, including the Female Sexual Function Index (FSFI) and The Incontinence
      Questionnaire Urinary Incontinence Short Form (ICIQ-UI SF), were administered preoperatively
      and at the 6-month postoperative follow-up.
    

Detailed description: 
      Urinary incontinence, often seen in women aged 30 to 60, involves Stress Urinary Incontinence
      (SUI) in most cases. It significantly affects life, impacting physical, emotional, and sexual
      well-being. Severe cases can lower sex drive and cause vaginal dryness, affecting not just
      the individual's sex life but also relationships, leading to a lower quality of life overall.
      That's why looking at how SUI affects sexual aspects is crucial.

      The study aimed to see how the distance between the mesh and urethra after transobturator
      tape (TOT) surgery might affect sexual function in patients who no longer experienced
      incontinence. Patients were divided based on this distance, and surveys like the Female
      Sexual Function Index (FSFI) and The Incontinence Questionnaire Urinary Incontinence Short
      Form (ICIQ-UI SF) were used before and six months after surgery.
    

Intervention name(s): transobturator tape
Intervention type(s): Procedure
Intervention description(s): transobturator tape :The surgeon makes a small incision in the vagina and small incisions in the right and left groin. The surgical process is similar to the retropubic approach, but the mesh passes through the groin muscles rather than the abdominal wall. transperineal ultrasound: patients who underwent TOT and were evaluated with transperineal ultrasonography, women with incontinence 6 months after the surgery showed discrepancies in the movement of the urethra with the sling compared to continent women, along with asymmetry between the mesh arms, bladder neck descent, and varied sling positions.
Observational model: Case-Only
Time perspective: Prospective
Sampling method: Probability Sample
Study population: 
        Between January 2020 and January 2022, a total of 82 continent patients ages 18 to 45 who
        underwent MUS surgery due to isolated SUI were included in the study
      
Keywords: Female stress incontinence; transobturator tape; transperineal ultrasound