Midurethral Sling Surgery Improves Sexual Function in Women with SUI, But Complications Persist: Review Suggests
USA: A recent review published in the International Urogynecology Journal highlights the evolving understanding of how midurethral sling (MUS) surgery influences sexual function in women with stress urinary incontinence (SUI), while also outlining strategies to address potential complications.
Stress urinary incontinence is a common condition among adult women and is known to significantly affect quality of life, including intimate health and sexual well-being. Over the years, MUS procedures have emerged as the preferred surgical treatment due to their effectiveness and minimally invasive nature. However, their broader impact on sexual function has remained an area of ongoing research.
In the review, led by Minneh Song from the School of Medicine at Case Western Reserve University, researchers analyzed evidence from studies published between 2014 and 2025. The aim was to assess changes in sexual function following MUS surgery and to examine available approaches for managing complications or treatment failure.
The researchers reported the following findings:
- The review analyzed data from 98 peer-reviewed studies evaluating outcomes after midurethral sling (MUS) surgery.
- Most women showed improvement or preservation of preoperative sexual function following MUS placement.
- Improvement in sexual function is likely associated with relief from incontinence symptoms, reducing anxiety and discomfort during intercourse.
- Outcomes varied across patients depending on sling type, follow-up duration, and individual patient characteristics.
- While many patients benefited, a subset experienced postoperative complications requiring additional management.
- Reported complications included mesh exposure and recurrence of urinary incontinence.
- These complications can negatively impact both physical comfort and sexual function, necessitating close postoperative follow-up.
- A range of management strategies is available based on the severity and type of complication.
- Conservative treatments include pelvic floor muscle training and interventions such as steroid injections.
- More complex or persistent cases may require surgical interventions, including sling adjustment or removal, urethral bulking, or repeat incontinence procedures.
The authors emphasize that while current evidence is encouraging, there is still a need for more robust long-term data. Future studies using standardized and validated tools to assess sexual function could provide clearer guidance for clinicians and help refine patient-centered treatment strategies.
Overall, the findings reinforce the role of midurethral sling surgery as an effective treatment for SUI, with generally favorable outcomes for sexual health. At the same time, they highlight the importance of individualized care and proactive management of complications to ensure optimal results for patients.
Reference:
Song M, Wong TR, Isali I. Midurethral Sling Surgery: Impacts on Sexual Function and Approaches to Complications. Int Urogynecol J. 2026 Jan 22. doi: 10.1007/s00192-025-06504-4. Epub ahead of print. PMID: 41569410.
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