Route matters: comparing vaginal (TOT) and laparoscopic (MERT-Burch) approaches in stress urinary incontinence and postoperative sexual function recovery
Journal of Sexual Medicine, cilt.23, sa.5, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 23 Sayı: 5
- Basım Tarihi: 2026
- Doi Numarası: 10.1093/jsxmed/qdag106
- Dergi Adı: Journal of Sexual Medicine
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, Gender Studies Database, MEDLINE, Psycinfo, Public Affairs Index, Academic Search Ultimate (EBSCO), Biomedical Reference Collection: Corporate Edition (EBSCO)
- Anahtar Kelimeler: stress urinary incontinence, female sexual function, transobturator tape, (TOT), Burch colposuspension, postoperative sexual recovery
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Background: Stress urinary incontinence (SUI) negatively affects women’s sexual well-being and quality of life through anxiety about urine leakage during intercourse. Aim: To compare the effects of vaginal (transobturator tape, TOT) and laparoscopic (Multiple Endoclip Retraction Technique-Burch, MERT-Burch) routes on postoperative sexual function, quality of life, and time to comfortable coitus. Methods: This retrospective study included 114 sexually active women who underwent TOT (n = 55) or laparoscopic MERT-Burch colposuspension (n = 59) between January 1, 2021, and August 5, 2025. Pre- and 6-month postoperative data were collected using validated questionnaires: International Consultation on Incontinence Questionnaire–Short Form (ICIQ-SF), Urogenital Distress Inventory–6 (UDI-6), Incontinence Quality of Life Questionnaire (I-QOL), Female Sexual Function Index (FSFI), and International Index of Erectile Function–5. Complications were graded by the Clavien–Dindo system. Outcomes: Primary outcomes were postoperative improvement in sexual function and the timing of first and comfortable coitus. Results: The mean age and body mass index were similar between groups. The MERT-Burch group resumed sexual activity significantly earlier (first coitus: 7 vs 35 days; comfortable coitus: 15 vs 54 days, P < .001). Both procedures improved ICIQ-SF, UDI-6, I-QOL, and FSFI scores (P < .001). Persistent dyspareunia occurred in 14.5% of TOT patients but in none after MERT-Burch. No major complications were recorded. Clinical Implications: Route of surgery affects postoperative sexual comfort and the time to first comfortable coitus, favoring the non-vaginal, mesh-free laparoscopic approach. Strengths & Limitations: Use of validated scales and the novel “first comfortable coitus” parameter are strengths; retrospective design and limited follow-up are limitations. Conclusion: Both techniques effectively restore continence, but the laparoscopic MERT-Burch provides earlier and more comfortable sexual recovery, establishing “first comfortable coitus” as a practical indicator of postoperative sexual healing.