Sexual Dysfunction After Trocar-Guided Transvaginal Mesh Repair of Pelvic Organ Prolapse

Altman, Daniel; Elmér, Caroline; Kiilholma, Pentti; Kinne, I; Tegerstedt, Gunilla; Falconer, Christian

doi:10.1097/aog.0b013e3181922362

Cited by 78 publications

(37 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Postoperative dyspareunia is the area of sexual dysfunction that has received the greatest attention relating to urogynecological surgery. Again findings from previous studies are conflicting and some studies show an increased risk for dyspareunia after surgery whereas others detected no change [8][9][10][11][12][13][14]. We found that the number of women with dyspareunia decreased postoperatively, even if almost half of the women who answered the question (42/ 98) had some dyspareunia one year after the operation.…”

Section: Tablecontrasting

confidence: 49%

“…The deterioration was mainly attributed to negative effects in the partner related domain whereas the behavioral-emotive and physical domains showed no significant changes. To some extent this concurs with a previous cohort study showing that transvaginal mesh is associated with deteriorating partner related sexual function [8]. Although partner related sexual dysfunction after prolapse surgery is a recurrent finding in studies on pelvic organ prolapse surgery the mechanisms for this finding are poorly understood.…”

Section: Commentcontrasting

confidence: 38%

“…Nonetheless, it remains unclear how, and to what extent, sexual dysfunction relates to pelvic reconstructive surgery. Some studies suggest that sexual dysfunction is a common sequela after mesh augmented reconstructive surgery [8,9], others suggest that surgery has no effect [10][11][12], or even improve sexual function domains [13,14]. Ambiguous results have also been shown for other quality of life domains in relation pelvic organ prolapse surgery.…”

Section: Introductionmentioning

confidence: 83%

See 2 more Smart Citations

Quality of life after Uphold™ Vaginal Support System surgery for apical pelvic organ prolapse—A prospective multicenter study

Rahkola-Soisalo

Altman

Falconer

et al. 2017

European Journal of Obstetrics & Gynecology and Reproductiv

Self Cite

View full text Add to dashboard Cite

Objective: To study the effects on quality of life in women operated for apical pelvic organ prolapse using the Vaginal Uphold TM System. Study design: In this prospective cohort study, women (n = 207) with symptomatic apical prolapse, with or without cystocele, were operated using the Uphold TM Vaginal Support System. Follow-up for quality of life was performed at 12 months after surgery, and assessed by the PFDI-20, and PFIQ-7, and sexual function by the PISQ-12. We used odds ratios (ORs) with 95% confidence intervals (CIs) for outcome association analyses using logistic regression.Results: At one-year follow-up majority of women experienced an overall postoperative improvement in quality of life (p < 0.001). One year after surgery Uphold TM operation alone increased the risk for prolapse related bother as compared to Uphold TM combined with anterior colporraphy (POP-IQ-7; OR 2.1; 95% CI 1.01-4.3). The frequency of dyspareunia decreased postoperatively (p = 0.004), however, after one-year, overall sexual function deteriorated significantly (p < 0.001). The worsening in sexual function scores was mainly attributed to the partner related domain, whereas the behavioral-emotive and physical domains showed no significant changes. Conclusion: Apical prolapse repair using Uphold TM improved quality of life among our patients but worsened overall sexual function postoperatively. 2016 Elsevier Ireland Ltd. All rights reserved. IntroductionAlthough the restoration of vaginal topography often results in improvements in pelvic organ prolapse symptoms the incongruence between objective and subjective outcomes in pelvic organ prolapse surgery is well established [1][2][3]. As a consequence, the focus of pelvic organ prolapse surgery has pivoted towards patients centered outcomes and quality of life measures, [4-6] rather than simply measuring pelvic anatomy outcomes of surgery.In women after pelvic organ prolapse surgery quality of life measures may entail a variety of domains of which the effects on sexual function has received perhaps the most attention [7]. Nonetheless, it remains unclear how, and to what extent, sexual dysfunction relates to pelvic reconstructive surgery. Some studies suggest that sexual dysfunction is a common sequela after mesh augmented reconstructive surgery [8,9], others suggest that surgery has no effect [10][11][12], or even improve sexual function domains [13,14]. Ambiguous results have also been shown for other quality of life domains in relation pelvic organ prolapse surgery.We have previously reported on the safety and efficacy outcomes and subjective relief of condition specific symptoms after using the Uphold TM Vaginal Support System [15]. In the present study we assessed quality of life and sexual function outcomes following Uphold TM surgery in a prospective cohort of women with apical prolapse and with or without concurrent cystocele.

show abstract

Section: Tablecontrasting

confidence: 49%

Section: Commentcontrasting

confidence: 38%

Section: Introductionmentioning

confidence: 83%

See 1 more Smart Citation

Quality of life after Uphold™ Vaginal Support System surgery for apical pelvic organ prolapse—A prospective multicenter study

Rahkola-Soisalo

Altman

Falconer

et al. 2017

European Journal of Obstetrics & Gynecology and Reproductiv

Self Cite

View full text Add to dashboard Cite

show abstract

“…At this point, short-term data (2-year follow-up or less) suggest that its use for anterior compartment defects may provide an advantage over nonmesh augmented repairs [1,2], but at what cost [3,4]?…”

mentioning

confidence: 99%

Do guns kill people or...? The mesh dilemma

Butrick¹

2010

Int Urogynecol J

View full text Add to dashboard Cite

“…The graft is placed superficial to the fascia in mesh-augmented surgery, whereas it is placed close to the viscus in mesh replacement surgery (A. Rane, personal communication) [17]. Always consider ''His'' and ''Her'' pareunia while planning surgery-male dyspareunia seems invariably associated with stiff graft material exposure, while female dyspareunia seems to be more associated with excessive graft tensioning or with shortening and narrowing of the vaginal canal [18][19][20][21].…”

mentioning

confidence: 99%

Pearls and Pitfalls of Mesh Surgery

Rane

Iyer

2012

J Obstet Gynecol India

View full text Add to dashboard Cite

AbstractsObjectives This article attempts to offer balanced insight into the use of transvaginal mesh for pelvic organ prolapse especially in the light of the negative publicity in recent times. The role of transvaginal mesh has been in the limelight for a number of reasons and it is important to address this issue in an objective, fair, and balanced manner. The conventional approach to prolapse surgery has undergone a paradigm shift and the principles of mesh replacement surgery sharply contrast with many traditionally held beliefs. This has created a new set of challenges that has revealed a sharp division of opinion among specialists and sub-specialists alike. Conclusion The article is an attempt to explain how mesh surgery can be safely and efficiently performed in carefully selected cases and is based on the combined wisdom of some of the leading surgeons in the sub-specialty today.Keywords Reconstructive pelvic floor surgery Á Use of mesh Á Pearls and pitfalls Although the problem of urinary incontinence and pelvic organ prolapse has been recognized since antiquity, the first mention in the modern era of medicine was only in the midnineteenth century when Marion Sims first sought to establish the relationship of urology and gynecology. The life expectancy for women has almost doubled through the 20th century. With a significant increase in the post-menopausal female population, there is a growing demand for improved quality of life and management of pelvic floor dysfunction [1]. The surgery for pelvic organ prolapse has evolved over the past 200 years and continues to be influenced by dynamically changing concepts, involving not only newer approaches to the difficult problem of recurrent pelvic organ prolapse, but also a renewed understanding of pelvic floor anatomy.It is important that one's approach toward surgery for pelvic organ prolapse (POP) be dictated by patient symptoms. Indeed, operating on ''asymptomatic'' patients is best avoided because the only thing she will get post-operatively is ''symptoms'' [2,3]. Assessment of prolapse needs to done mindful of the day-to-day situations that aggravate it; for example, examining a woman after a bout of exercise. The dorsal or the lithotomy position may not reveal an enterocele, whereas a squatting or a semi-crouching position might be useful [4]. One should never hesitate to perform per rectal or bidigital examination which is not only useful in distinguishing between enteroceles and rectoceles, but also effectively evaluates damage to the perineal body. Investigation modalities like ultrasound, MRI, and defecation proctography are underutilized albeit extremely useful adjuncts in the pre-operative planning, especially for recurrent genital prolapse and often reveal

show abstract

Sexual Dysfunction After Trocar-Guided Transvaginal Mesh Repair of Pelvic Organ Prolapse

Abstract: II.

Cited by 78 publications

References 31 publications

Quality of life after Uphold™ Vaginal Support System surgery for apical pelvic organ prolapse—A prospective multicenter study

Quality of life after Uphold™ Vaginal Support System surgery for apical pelvic organ prolapse—A prospective multicenter study

Do guns kill people or...? The mesh dilemma

Pearls and Pitfalls of Mesh Surgery

Contact Info

Product

Resources

About