Discussion
incontinence, TVT, urinary incontinence symptoms from the baseline, urinary incontinence, primary SUI, sexual dysfunction, SUI
SECONDARY, URINARY INCONTINENCE, INCONTINENCE, URINARY INCONTINENCE
Our results show that at 3 years both TVT and PAHG treatments improve incontinence-related QoL and sexual dysfunction and physical and social functioning of HRQoL. However, PAHG patients still suffered more from incontinence related distress at 3 years compared to the TVT group. This finding is in line with better objective and subjective efficacy of TVT compared to PAHG [In UDI-6 and IIQ-7, total scores showed lessened distress caused by urinary incontinence symptoms from the baseline in both groups, which is in line with previous studies after mid-urethral sling surgery [Many studies have shown improved sexual function after mid-urethral sling surgery [Urinary incontinence negatively impacts HRQoL [This study provides unique midterm data on the impact of TVT and PAHG on QoL and sexual function. As a strength of our study, we included only women with primary SUI, whereas previous studies evaluating PAHG were conducted with women suffering from mixed urinary incontinence and/or previously failed anti-incontinence surgery [There are also limitations to address. Our study on QoL and sexual function was a secondary analysis, and the power might not have been adequate to show a statistically significant difference in all end-points. As we studied only TVT and PAHG treatments, our findings cannot be extended to other mid-urethral slings or bulking agents. We didn’t request the reasons for sexual inactivity and therefore cannot determine whether the reason for inactivity was SUI related. However, no significant increase or decrease in sexuality was seen after 3 years. And finally, we had a rather high number of women who crossed over to the other treatment. However, there were no differences when compared to the results in treatment received or intention-to-treat.