Assessing the impact of male pelvic mesh surgery on male sexual function: Clinical evaluation of erectile, ejaculation and orgasm functions in men who underwent AdVance male sling surgery
1: AndroUrology Centre, Australia
Objectives: To evaluate the impact of AdVance male sling on male sexual function parameters in the current climate of pelvic mesh and sexual dysfunction debate.
Material and Method: An independent survey was conducted following internal ethics approval, on all men who received AdVance male sling between 2012 to 2015 to evaluate the impact of mesh surgery on erectile, ejaculatory and orgasmic functions, with a minimum 2-year follow up study. Patient demographics, clinical outcomes and validated questionnaires such as the Brief Sexual Function Inventory (BSFI), International Index of Erectile Function (IIEF), Patient Global Impression of Improvement (PGI-I) and International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) were recorded.
Result: A total of 50 men with a mean age 61.8 (48-76) years received AdVance sling over the 3-year period and 45 men reported good erection (preoperative IIEF-5 score ≥ 17) with or without oral and/or intracavernosal erectile drugs. There was no intraoperative complication and 3 (6%) patients reported temporary pain and/or dysaesthesiae in the inner thigh at 3 months postoperative. Improvement in erectile function was reported in 5 (10%) patients (increase in IIEF-5 score ≥ 5 points), 10 (20%) in ejaculatory function and 14 (28%) in orgasmic function. Twenty (40%) patients rated an increase in the overall satisfaction on BSFI and IIEF scores. Two (4%) patients reported lower orgasmic score (on IIEF question 10). Social continence (defined as 0 to 1 pad use) was achieved in 40 (80%) and 35 (70%) of patients at 12 and 24 months of follow up, with significant improvement in PGI-I (mean 1.5) and ICIQ-SF (14.5 vs. 4.2). Men with higher continence rate were more likely to report better male sexual function (OR 3.0;95% CI 0.56-16.3, p=0.20).
Conclusions: Despite the reported adverse effect of sexual dysfunction following pelvic mesh in the female population, AdVance male sling appears to improve male sexual function with regards to erectile, ejaculatory and orgasm domains.
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