OBJECTIVE: The purpose of this study was to assess sexual function in women after surgery for stress urinary incontinence and/or pelvic organ prolapse (UI/POP) at 3 and 6 months with the Pelvic Organ Prolapse Urinary Incontinence Sexual Questionnaire (PISQ). STUDY DESIGN: Of 269 eligible women participating in a trial of prophylactic antibiotic use with suprapubic catheters, 102 (37.9%) agreed to participate in a sexual function study. Women underwent a variety of anti-incontinence and reconstructive surgeries. Sexual function and urinary incontinence were assessed preoperatively and at 3 and 6 months, postoperatively, with the PISQ and Incontinence Impact Questionnaires (IIQ-7). Paired t tests compared changes over time. Logistic regression compared worsening PISQ versus other variables. Generalized McNemar test compared individual questions preoperatively and postoperatively. Significance was set at P < .05. RESULTS: Mean age was 47.1 (23-85) years, and 64% of women were premenopausal. Seventy-five (74%) women completed questionnaires at 3 or 6 months. Sexual function scores improved after surgery as did IIQ-7 scores (PISQ 89 vs 95, P < .001; IIQ-7 = 52 vs 13, P < .001). The Behavioral Emotive domain scores did not change at 3 to 6 months compared with preoperative scores P = .57), whereas the Physical domain improved (P < .001). Worsening PISQ scores were independent of age, type of surgery, hysterectomy, complications, or hormonal status (logistic regression, all P < .05). CONCLUSION: Sexual function scores in women improve after surgery for UI/POP as did improvement of incontinence at 3 to 6 months after surgery.