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Introduction: Aim of this cross-sectional study was to analyze the sexual function of women after tension-free vaginal tape (TVT) procedure. Patients and Methods: To evaluate the female sexual function after the TVT procedure, we designed a 36-item questionnaire including 21 questions on incontinence, 15 questions on sexuality and 3 questions on the personal impression of the procedure. Diagnostic workup consisted of a detailed medical history, urinalysis, postvoid residual urine volume assessment, ultrasound of the kidney and a urodynamic study. Results: Fifty-two women completed the entire questionnaire. Overall, 82.7% of the women were satisfied with the TVT procedure. A proportion of 74.0% indicated that they became totally continent after the operation. One third of the sexually active women reported an improvement of their sexual life after TVT, 14.3% a worsening, and 52.4% reported no change. Deterioration of sexual function was significantly associated with de novo urge, dyspareunia and sensation of postvoid residual urine volume. Conclusion: In summary, our investigations showed that the influence of the TVT procedure on female sexual function is evident, but of low impact, and in general will not be of relevance.

Aim: To assess the role of Adjustable Continence Therapy® (ACT) as a minimally invasive treatment for women with urinary incontinence (UI) after failed previous incontinence surgery or when conventional surgical treatment was considered problematic. Material and Methods: The ACT device consists of two balloons implanted at the level of the bladder neck using a paraurethral/vaginal approach with the aim of coapting the urethra. Balloon filling can be adjusted postoperatively via a port placed in the labia majora. Results: 41 women with a mean age of 73 (range 42–93) years were evaluated. 15 (38%) women had failed previous UI surgery with 83% having undergone prior pelvic surgery. Mean follow-up was 25 (5–60) months. Adjustment of the ACT balloons was necessary in 28 women (69%). Overall, 44% of women became fully continent, 15% reported a significant improvement of UI, a further 29% had a slight improvement, while 12% indicated no change. ACT-related complications occurred in 16 (39%) patients, including balloon migration, transient urinary obstruction and balloon leakage. Conclusions: ACT is an attractive minimally invasive option for women with UI with previous failed incontinence surgery or when conventional incontinence surgery carries a high risk of failure.

A 69-year-old woman presented with a solid homogenous mass in the area of the posterior wall of the urinary bladder. A transvaginal approach was used to remove the mass located in the vesicovaginal septum. Histology revealed a benign smooth spindle cell tumor and immunohistochemistry confirmed leiomyoma.