We sought to determine if postoperative urinary incontinence (UI) symptoms are associated with (1) sexual activity status and (2) sexual function using validated health-related quality of life instruments. In this mailed cross-sectional survey of 687 women who underwent stress incontinence surgery, 437 (63.6%) completed a questionnaire protocol. Clinical and sociodemographic factors independently associated with sexual activity status were identified with logistic regression. Sexually active respondents completed the Pelvic Organ Prolapse and Urinary Incontinence Sexual Function Questionnaire (PISQ-12) as a measure of sexual function. Factors independently associated with sexual function were identified with linear regression. Sexual activity was reported by 57.6% (252/437). The likelihood that a respondent was sexually active was moderated by an interaction between age and UI symptom severity (p = 0.059). Among the sexually active women, increasing UI symptom severity was associated with poorer sexual function (r = -0.42, p < 0.001). The severity of postoperative recurrent or persistent UI is associated with a lower probability of being sexually active and an adverse effect on sexual function.
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