Effects of mesh surgery on sexual function in pelvic prolapse and urinary incontinence

Abstract

Purpose: We aimed to determine pre-operative and post-operative sexual function scores of patients who underwent four-arm polypropylene mesh implantation surgery to treat urinary incontinence and pelvic organ prolapse. Materials and Methods: A prospective study from January 2011 to November 2015 including patients (n: 72) submitted to surgical mesh implantation (four-arm anterior mesh implant (Betamix POP4®, Betatech Medical, Turkey) questioned the patients with Female Sexual Function Index evaluation form. The questionnaire was applied to all patients at pre-operative, post-operative 3rd month and post-operative 1st year periods. Results: The mean age of the patients was 47.2±7.1 years. The mean Body Mass Index (kg/m2) was 28.7±3.7. The average of incontinence duration (year) was 4.6±2.6 and the average for operation time (min) was 35.7±2.1. After the urinary incontinence and pelvic organ prolapse surgery, it was observed that incontinence complaints of patients reduced. Furthermore, there was a positive change in quality of life and sexual function of patients at the post-operative period. There was a statistically signifi cant increase according to Female Sexual Function Index score among all three periods (16%, 86% and 100% respectively, p=0.001) and improvement of sexual functions was observed. Conclusions: Transvaginal mesh use in the surgical treatment of pelvic organ prolapse improves quality of life. However, risk factors such as transvaginal mesh usage indication, surgical technique and experience of the surgeon, suitability of the material, the current health status of the patient and postoperative personal care of the patient may affect the success of operations.

Quality of Life Following Pelvic Organ Prolapse Treatments in Women: A Systematic Review and Meta-Analysis

“…There were two main procedures for vaginal surgeries: reconstructive (in two subgroups, including repair with natural tissue [ 17 , 19 , 20 , 23 , 24 , 31 , 36 , 37 , 38 , 60 , 61 , 63 , 64 , 65 , 66 ] ( Table 2 ) and repair with mesh [ 7 , 9 , 12 , 21 , 25 , 26 , 29 , 32 , 35 , 39 , 40 , 41 , 42 , 43 , 44 , 55 , 62 , 67 , 68 , 69 , 78 , 82 , 83 , 85 ]) ( Table 3 ) and obliterative surgeries [ 18 , 27 , 60 , 71 , 72 , 73 , 86 ] ( Table 4 ). In one study, obliterative surgery and sacrospinous fixation in older postmenopausal women were compared, and the QoL was better in the sacrospinous group [ 18 ].…”

“…For estimating the effect of surgical intervention on sexual activity, 14 studies were included [ 9 , 12 , 20 , 24 , 37 , 39 , 42 , 43 , 55 , 56 , 61 , 75 , 76 , 85 ]. Among them, 10 studies used the PISQ questionnaire.…”

“… Pooled mean difference of the effect of surgical intervention (vaginal and abdominal surgery) on total quality of sexual activity. (PSIQ: Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire, FSFI: Female Sexual Function Index) [ 9 , 20 , 24 , 37 , 39 , 42 , 43 , 55 , 56 , 61 , 75 , 76 , 85 ]. …”

Baseline measures for women with mesh complications accessing a pain service (as part of the London Complex Mesh Centre)

“…11 These physical complications effect the neurological, vascular and endocrine systems which may also have an impact on sexual function. 16…”

“…11 These physical complications effect the neurological, vascular and endocrine systems which may also have an impact on sexual function. 16 Sexual arousal is associated with increased sensory perception from the genital area (as well as other body Patients with mesh were significantly older than those with chronic pelvic pain (59 years vs 40 years, p < .0001) and were more likely to be of white ethnicity (94.8% vs 83.7%, p = .005). parts) and through the process of central sensitisation which may also contribute to pain associated with sex.…”