Clitoral Blood Flow Changes After Surgery for Stress Urinary Incontinence: Pilot Study on TVT Versus TOT Procedures

Caruso, Salvatore; Rugolo, Salvatore; Bandiera, Sebastiano; Mirabella, Daniela; Cavallaro, Antonio; Cianci, Antonio

doi:10.1016/j.urology.2007.04.045

Cited by 64 publications

(35 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…After TVT, the vascularization of clitoral erectile tissues might be altered, as shown by colour Doppler ultrasonography. 99 By contrast, TOT procedures are not associated with orgasmic dysfunction, as confirmed by Bekker et al 100 They showed that the dorsal nerve of the clitoris was not disturbed during placement of a TVT-O, whereas autonomic innervation of the vaginal wall and clitoris was disrupted by the TVT procedure. Elzevier et al 101 reported deterioration in clitoral sensitivity and tumescence after TOT and TVT-O in 11.5% and 10% of cases, respectively.…”

Section: In 2012mentioning

confidence: 92%

Stress urinary incontinence and LUTS in women—effects on sexual function

2014

View full text Add to dashboard Cite

The sexual impact of urinary incontinence in women depends on a host of parameters, including physical, psychological, social and cultural dimensions. Evaluation of the effects of stress urinary incontinence (SUI) and lower urinary tract symptoms on sexual function is often biased by their common association with other pelvic floor disorders, such as pelvic organ prolapse, which also affect sexual satisfaction. Indeed, these complexities are reflected in the literature, which shows considerable disparity in sexual functional characteristics in women with incontinence both before and after treatment. This discordance is further emphasized by heterogeneity in study design, quality and analysis. Here, we describe the nature of sexual dysfunction in women with incontinence, including coital incontinence. The various treatments for SUI, which include transvaginal tape surgeries, can also affect sexual function, positively or negatively. Coital incontinence seems to be a good predictor of an improvement in postoperative sexual parameters: its cure, achieved by >90% of women, to a large extent explains the sexual benefits reported in several studies. By contrast, deterioration in sexual function is sometimes reported after surgery, with de novo or worsened dyspareunia being the most common cause. The literature does not contain any convincing arguments for one treatment or another on the basis of sexual functional outcome.

show abstract

Section: In 2012mentioning

confidence: 92%

Stress urinary incontinence and LUTS in women—effects on sexual function

2014

View full text Add to dashboard Cite

show abstract

“…Indeed, clitoral blood flow was reduced after tension-free vaginal tape. 13 Others have shown iliohypogastric and pudendal arterial blood flow may be compromised following radical as opposed to simple abdominal hysterectomies.…”

Section: Anatomic Considerationsmentioning

confidence: 99%

Impact of gynecological surgery on female sexual function

Pauls

2010

Int J Impot Res

View full text Add to dashboard Cite

Sexual function is complex and involves interaction of many factors, including emotional connection, body image, intact physical response and partner sexual function. Disease processes such as abnormal uterine bleeding, endometriosis, urinary incontinence and pelvic organ prolapse may have a negative impact on various parameters of sexual health. Gynecological surgery to address these common complaints may correct the pathological process. However, despite improvements in symptoms related to the disease, improvements in sexuality are not guaranteed and occasionally there may be deteriorations. This review will summarize the current literature assessing sexual symptoms following benign gynecological surgery, including hysterectomy, and bilateral salpingo-oophorectomy, tubal ligation, anti-incontinence surgery and pelvic organ prolapse reconstruction with and without mesh. In the majority of cases, sexual function and quality of life benefit from these surgical interventions. However, it is critical that physicians remain aware of the potential for negative outcomes. Subjects who experience worsening should undergo thorough evaluation early in the postoperative period in order to mitigate symptoms. Treatment modalities for sexual dysfunction following surgery should be the focus of future research.

show abstract

“…Caruso et al evaluated perfusion parameters of the clitoral arteries before and 6 months postoperatively in women who [30]. Their study used translabial colour Doppler ultrasonography, demonstrating that the mean pulsatility index and the mean peak systolic velocity were significantly lower and that the mean resistance index was significantly higher in the TVT group compared with the pre-treatment values (P<0.5).…”

Section: Discussionmentioning

confidence: 99%