Aim: To evaluate sexual functions of women having stress urinary incontinence (SUI) preoperatively and 6 months and 12 months after undergoing a transobturator tape (TOT) ± pelvic organ prolapse (POP) surgery. Methods: One hundred-ninety-five women with SUI ± POP were recruited and 150 sexually active women who had clinical ± urodynamic SUI and underwent TOT ± POP surgery were included in this prospective study. Urogynecologic symptoms were evaluated preoperatively, at 6 months, and 12 months by Female Sexual Function Index (FSFI). Results: One hundred fifty women completed the study. Seventy-four underwent TOT-only and 76 underwent TOT + concomitant surgery. Mean total scores of FSFI were 21.7 ± 7.8, 22 ± 8.7, and 22.1 ± 8 in the preoperative period, postoperative 6, and 12 months, respectively. There was significant improvement in desire and total scores in the TOT-only group, whereas there was no significant difference in the TOT + concomitant surgery group except for significant worsening in the lubrication domain. The frequency of sexual intercourse increased while that of coital incontinence decreased after surgery. Conclusions: In our study, TOT was associated with decrease in coital incontinence and significant improvement in desire. In addition, there was significant improvement in FSFI desire and total scores in the TOT-only group, whereas no significant difference was observed in the TOT + concomitant surgery group except for the worsening of lubrication.