TENSION-FREE TECHNIQUES IN UROGYNAECOLOGICAL SURGERY

The new tension-free techniques for treatment of either stress urinary incontinence or pelvic organ prolapse are shown. They are divided as follows. Techniques for the anterior compartment: TVT (Tension-free Vaginal Tape), Retropubic TUS (Tension-free Urethral Suspension), TOT (Transobturator Tape), Prepubic TUS (Tension-free Urethral Suspension), TCR (Tension-Free Cystocele Repair), Retropubic TICT (Tension-free Incontinence Cystocele Treatment), Prepubic TICT (Tension-free Incontinence Cystocele Treatment); Techniques for the apical compartment: Indirect abdominal colposacropexy; Techniques for the postero- apical compartment: Posterior IVS; Techniques for the posterior compartment: Colpoperineoplasty with mesh. Both a correct diagnosis and an appropriate procedure are the right key to achieve a greater therapeutic success.

Evaluation of the Female Sexual Function after Vaginal Surgery Using the FSFI (Female Sexual Function Index)

Urinary Incontinence (UI) and Pelvic Organ Prolapse (POP) have a detrimental effect on Female Sexual Function (FSF). We decided to focus on the effect of vaginal surgery for UI and/or POP on FSF. Materials and Methods 72 women (aged 42–80, mean age: 62) were given the FSFI questionnaire after undergoing the following operations: 54 Tension-Free Vaginal Slings (TFVS), 12 Kelly plications, 3 hysterectomies+Kelly 2 Tension-Free Vaginal Slings+Kelly 1 hysterectomy+Kelly+posterior IVS. Results 35 women did not answer the questionnaire, 6 women were sexually inactive and answered only partially; 31 patients answered completely. Mean pre- and postoperative scores were, respectively, 25.26 and 25.22 (normal >26.55). 9 patients had a normal preoperative score, whereas 22 a pathological score. The FSFI score did not change postoperatively in 26 women; it worsened in 3 and improved in 2 women treated because of coital incontinence. Conclusions Vaginal surgery for UI and/or POP does not seem to affect FSF in the great majority of cases; conditions may worsen or improve, the latter definitely resulting from the treatment of Coital Incontinence. The high number of patients not answering the questionnaire deserves further studies and it could be - at least partially - explained on the basis of psychological and/or cultural problems regarding the highly emotional issues of sex, incontinence and prolapse.