Does sexual function change after surgery for stress urinary incontinence and/or pelvic organ prolapse? A multicenter prospective study

Rogers, Rebecca G.; Kammerer-Doak, Dorothy; Darrow, Amy; Murray, Kristen; Qualls, Clifford; Olsen, Ambre L.; Barber, Matthew D.

doi:10.1016/j.ajog.2006.09.021

Cited by 135 publications

(105 citation statements)

References 8 publications

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“…Both the patients and their partners need to be considered here. The reports in the literature on sexual function after (mesh-based) surgery of the pelvic floor are inconsistent [15,32,33], and further research into dyspareunia after different surgical procedures is urgently required.…”

Section: Discussionmentioning

confidence: 99%

Quality of Life, Sexuality, Anatomical Results and Side-effects of Implantation of an Alloplastic Mesh for Cystocele Correction at Follow-up after 36 Months

Fünfgeld¹,

Stehle²,

Henne

et al. 2017

Geburtshilfe Frauenheilkd

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ABSTR AC TIntroduction Pelvic organ prolapse can significantly reduce quality of life of affected women, with many cases requiring corrective surgery. The rate of recurrence is relatively high after conventional prolapse surgery. In recent years, alloplastic meshes have increasingly been implanted to stabilize the pelvic floor, which has led to considerable improvement of anatomical results. But the potential for mesh-induced risks has led to a controversial discussion on the use of surgical meshes in urogynecology. The impact of cystocele correction and implantation of an alloplastic mesh on patientsʼ quality of life/sexuality and the long-term stability of this approach were investigated. MethodIn a large prospective multicenter study, 289 patients with symptomatic cystocele underwent surgery with implantation of a titanized polypropylene mesh (TiLOOP ® Total 6, pfm medical ag) and followed up for 36 months. Both primary procedures and procedures for recurrence were included in the study. Anatomical outcomes were quantified using the POP-Q system. Quality of life including sexuality were assessed using the German version of the validated P-QoL questionnaire. All adverse events were assessed by an independent clinical event committee.Results Mean patient age was 67 ± 8 years. Quality of life improved significantly over the course of the study in all investigated areas, including sexuality and personal relationships (p < 0.001, Wilcoxon test). The number of adverse events which occurred in the period between 12 and 36 months after surgery was low, with just 22 events reported. The recurrence rate for the anterior compartment was 4.5 %. Previous or concomitant hysterectomy increased the risk of recurrence in the posterior compartment 2.8-fold and increased the risk of erosion 2.25-fold.Conclusion Cystocele correction using a 2nd generation alloplastic mesh achieved good anatomical and functional results in cases requiring stabilization of the pelvic floor and in patients with recurrence. The rate of recurrence was low, the patientsʼ quality of life improved significantly, and the risks were acceptable. . The most serious effect of pelvic organ prolapse is impairment of bladder and bowel function accompanied by incontinence and voiding disorders [2,3]. General well-being, personal relationships, particularly sexuality [4], and physical and social activities often suffer from the effects of prolapse [5,6]. The incidence of pelvic organ prolapse in women has increased in parallel with the general increase in life expectancy, and the likelihood that women aged 80 years will require surgical intervention (e.g. hysterectomy, pelvic floor reconstruction) is 12.2 % [7]. One in nine women is affected by prolapse [8]. Up to 30 % of patients require a repeat operation for recurrence within 5 years of the original procedure [9][10][11][12]. Surgical correction of prolapse should not just reposition the prolapsed pelvic organs, it should also restore the patientʼs quality of life or at least improve it. As the recurrence rate...

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Section: Discussionmentioning

confidence: 99%

Quality of Life, Sexuality, Anatomical Results and Side-effects of Implantation of an Alloplastic Mesh for Cystocele Correction at Follow-up after 36 Months

Fünfgeld¹,

Stehle²,

Henne

et al. 2017

Geburtshilfe Frauenheilkd

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“…This study demonstrates that pelvic floor symptoms are associated with low sexual arousal, infrequent orgasm, and dyspareunia in women over 40 years of age. Other studies have reported women with pelvic floor disorders often complain of sexual difficulties (2), but in some cases characterizations of female sexual function in prior studies were limited to a single measure of sexual well-being (4,13). In this study, we used a validated measure of female sexual function and focused on symptoms related to the four recognized categories of female sexual dysfunction.…”

Section: Discussionmentioning

confidence: 99%

Female Sexual Function and Pelvic Floor Disorders

Handa

Cundiff

Chang

et al. 2008

Obstetrics &Amp; Gynecology

196

113

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Objectives-Sexual function is an important dimension of adult life and yet very little is known about the relationships between female sexuality and chronic health conditions, including pelvic floor disorders. Our goal was to investigate the hypothesis that pelvic floor disorders are associated with female sexual problems, independent of other related factors.Methods-The study population included 301 adult women seeking outpatient gynecologic and urogynecologic care. Pelvic floor disorders were assessed with the Pelvic Floor Disorders Inventory-20 (PFDI) and the Pelvic Organ Prolapse Quantification examination. Sexual function was assessed with the Personal Experiences Questionnaire. Using ordinal regression analysis, we identified characteristics and conditions associated with decreased libido, infrequent orgasm, decreased arousal, and dyspareunia.Results-Sexual function was poorer among 78 women (26%) without a current sexual partner than among 223 with a partner (p<0.01). Among the 223 with a current partner, women with a high PFDI score were significantly more likely to report decreased arousal (p<0.01), infrequent orgasm (p<0.01) and increased dyspareunia (p<0.01). A similar pattern was observed for the urinary, colorectal-anal, and prolapse scales of the PFDI, although some associations were marginally significant. Stage III-IV prolapse was significantly associated with infrequent orgasm (p=0.02), but other sexual complaints were not more common with increasing prolapse stage.Conclusion-Pelvic floor symptoms are significantly associated with reduced sexual arousal, infrequent orgasm, and dyspareunia. Clinicians who care for women with pelvic floor disorders should be aware of this association and should specifically address sexual concerns with women seeking treatment of incontinence and prolapse.

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“…8 Four sites in this multicenter trial also recruited women to participate in a sexual function study, which has also been described previously. 9 These women form the present study population. We studied sexual function using a condition-specific, validated sexual function questionnaire, the Pelvic Organ Prolapse Urinary Incontinence Sexual Questionnaire (PISQ).…”

Section: Methodsmentioning

confidence: 99%

Posterior repair and sexual function

Komesu

Rogers

Kammerer-Doak

et al. 2007

American Journal of Obstetrics and Gynecology

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OBJECTIVE-The purpose of this study was to determine the effect of posterior repair (PR) on sexual function in patients who have undergone incontinence and/or pelvic reconstructive surgery.STUDY DESIGN-A cohort study of women who underwent incontinence and/or prolapse surgery was performed. Participants completed the pelvic organ prolapse urinary incontinence sexual questionnaire (PISQ) before and after the operation. PISQ scores were compared between women who underwent PR and women who did not. RESULTS-Of 73 study participants, 30 women underwent PR; 43 women did not (no PR).Although there was no difference in dyspareunia between groups pre-op, dyspareunia prevalence post-op was significantly lower in the no PR group. Preoperative PISQ scores were similar between groups. After the operation, both groups significantly improved their PISQ scores, without a difference between groups.CONCLUSION-Although the incidence of dyspareunia differed between PR and no PR groups, overall improvement in sexual function was reflected in improved total PISQ scores that occurred irrespective of PR performance. Keywords dyspareunia; incontinence; posterior repair; prolapse; sexual function Posterior compartment defects arise from abnormalities in rectovaginal connective tissue and its attachments within the pelvis. 1 Repair of this defect includes traditional posterior colporrhaphy, which is performed by plicating the patient's native rectovaginal connective tissue in the midline, or site specific posterior colporrhaphy, which is performed by plicating individual breaks in rectovaginal tissue. 1,2 Controversy exists whether posterior repair (PR) is associated with diminished sexual function or dyspareunia. Some authors have reported increased rates of dyspareunia after PR, whereas other authors have not. [3][4][5][6][7] Some authors have concluded that PR causes sexual dysfunction as a result of its association with dyspareunia. [3][4][5] Our objective was to evaluate prospectively pre-to postoperative changes in sexual function in women who had undergone PR compared with women who did not. MATERIALS AND METHODSThis analysis is based on a previously reported population of women enrolled in a randomized controlled trial that evaluated antibiotic prophylaxis for urinary tract infections after urinary incontinence and/or pelvic organ prolapse surgery. 8 Four sites in this multicenter trial also recruited women to participate in a sexual function study, which has also been described previously. 9 These women form the present study population. We studied sexual function using a condition-specific, validated sexual function questionnaire, the Pelvic Organ Prolapse Urinary Incontinence Sexual Questionnaire (PISQ). 10 This cohort study compared women who underwent PR with the group of women who did not undergo PR (no PR). Institutional review board approval was given, and written informed consent was obtained.Sexually active patients who had undergone pelvic reconstructive and/or incontinence procedures agreed to answer the PISQ...

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Does sexual function change after surgery for stress urinary incontinence and/or pelvic organ prolapse? A multicenter prospective study

Cited by 135 publications

References 8 publications

Quality of Life, Sexuality, Anatomical Results and Side-effects of Implantation of an Alloplastic Mesh for Cystocele Correction at Follow-up after 36 Months

Quality of Life, Sexuality, Anatomical Results and Side-effects of Implantation of an Alloplastic Mesh for Cystocele Correction at Follow-up after 36 Months

Female Sexual Function and Pelvic Floor Disorders

Posterior repair and sexual function

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