Assessment of Female Sexual Function Following Transobturator Midurethral Sling for Stress Urinary Incontinence 12 and 36 Months After Surgical Treatment in Postmenopausal Women

<b>Background/Objectives</b>: Stress urinary incontinence (SUI) is a common condition affecting sexual function, exercise activities, and quality of life, accompanied by psychological distress. The treatment of SUI includes conservative and surgical treatment which comprises tensions-free vaginal tapes in the form of retropubic (TVT) and transobturator tape (TOT or TVT-O). The TVT procedure is considered the gold standard, but the TOT procedure is a safe alternative due to a lower rate of bladder and bowel complications. The aim of this study is to evaluate the long-term effects of the surgical treatment of the TOT procedure after 36 months of follow-up on the sexuality of women with SUI. <b>Methods</b>: In the long-term evaluation, 3 years after surgery, 45 women with medical records sufficient for analysis participated in the project. The international standardized Female Sexual Function Index (FSFI) self-administered questionnaire was completed three times: before the surgery, 12 months after surgery, and 3 years after surgery. <b>Results:</b> Domain scores for arousal, lubrication, orgasm, and total score were lower in the follow-up group than before and after the surgery. The pain domain was the highest in the after-surgery group, slightly lower in the before-surgery group, and the lowest in the follow-up group. All the abovementioned differences were statistically significant. <b>Conclusions:</b> Three years after the surgical treatment of SUI, the results of our study patients deteriorated, especially in arousal, lubrication, and orgasm assessments, compared to outcomes 12 months after the procedure. In addition, the total FSFI score was lower 36 months after the surgery than the year before the surgery and lower than before the procedure. Also, pain during intercourse was more frequently reported, as opposed to the result year after the surgery, which was lower than before the operation.