To describe for the first time the Aberdeen Sexual Function Index (SFI-I) questionnaire and evaluate its ability to determine the changes in the sexual function in women following surgical interventions for SUI.

This study was a secondary analysis for data from the Single-Incision Mini-Slings (SIMS) study. SIMS was prospective multicenter randomized controlled trial (RCT) comparing mini-slings to standard mid-urethral slings for the surgical treatment of stress urinary incontinence (SUI) in women [1], conducted between February 2014 and September 2017, and enrolled 600 women from 21 hospitals across the UK [1]. Five Hundred and Ninety-Six (596) women were included in the analysis [1]. The women completed the validated Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire, IUGA-Revised (PISQ-IR) to assess ‘sexual function’ in women at baseline and 15-, 24- and 36- months follow-up. Women also completed the novel Sexual Function Improvement Index (SFI-I) and Patient Global Impression of Improvement (PGI-I) at 15-, 24-, and 36-months follow up. Pearson correlations were used to explore the relationship between the SFI-I and change on the PISQ-IR and the SFI-I and PGI-I.

The present study included 596 women for the analysis from the SIMS trial study. Of these women, 118, 101, and 102 answered the question on sexual function and completed the PISQ-IR at 15-, 24-, and 36-months respectively. This study found positive correlation between the SFI-I and PGI-I in the range 0.342 to 0.435 indicating both indices improve together. The correlation between SFI-I and PISQ-IR in the range -0.588 to -0.518 indicates improvement on one measure is also seen in the other. The diagnostic accuracy measures of specificity in the range 0.733 to 0.871 and positive predictive value in the range 0.844 to 0.900 indicates improvement on the SFI-I is a strong predictor of improvement on the PISQ-IR.

Our results showed that SFI-I was well received by women as noted form the high completion rate (approximately 70%). SFI-I correlates better with PGI-I compared to the PISQ-IR correlation with PGI-I.  Improvement on SFI-I post intervention is highly predictive and consistent with improvement on PIQ-IR scores, however 60% of the women who did not report/ perceive improvement on SFI-I had shown improvement in PISQ-IR scores. This could be interpreted that the novel SFI-I fails to predict women with improvements in sexual function/ PISQ-IR scores. However, unlike PISQ-IR, SFI-I is an index for the overall assessment of women’s sexual function, hence the most likely explanation is that it betters reflects their own and personal perception of any changes in their sexual function following the intervention.

The novel Aberdeen SFI-I provides accurate reflection of the patient perception of the impact of SUI surgery on their sexual function. SFI-I can be used in both clinical and research settings with more detailed questionnaires preserved to situations when more in-depth assessment of different sexual function domains is required.

Abdel-Fattah, M., MacLennan, G., Kilonzo, M., Assassa, R.P., McCormick, K., Davidson, T., McDonald, A., N’Dow, J., Wardle, J. and Norrie, J. (2017). The SIMS trial: adjustable anchored single-incision mini-slings versus standard tension-free midurethral slings in the surgical management of female stress urinary incontinence. A study protocol for a pragmatic, multicentre, non-inferiority randomised controlled trial. BMJ open, 7(8), p.e015111.