Analysis of changes in sexual function in women undergoing pelvic organ prolapse repair with abdominal or vaginal approaches

Gupta, Priyanka; Payne, J. E.; Killinger, Kim A.; Ehlert, Michael; Bartley, Jamie; Gilleran, Jason; Boura, Judy; Sirls, Larry

doi:10.1007/s00192-016-3066-9

Cited by 22 publications

(11 citation statements)

References 30 publications

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“…Dyspareunia in post-menopausal women is not uncommon even without POP, its entity is usually difficult to evaluate. The rate of de-novo dyspareunia among our sexually active patients was 10.3%, which is comparable to values reported by other authors [15,29], none of our patients referred pelvic pain attributable to sacrospinous ligaments stitches. Despite criticism of synthetic materials, recent Cochrane reviews, albeit with metanalyses biases, affirmed that the use of vaginal meshes lowers the risk of prolapse symptoms and of recurrent anterior vaginal prolapse when compared to biocompatible tissue and fascial repair [26,30].…”

Section: Discussionsupporting

confidence: 90%

Long-term experience with a novel uterine-sparing transvaginal mesh procedure for uterovaginal prolapse

Nicita

Villari

Marzi

et al. 2018

European Journal of Obstetrics & Gynecology and Reproductiv

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To evaluate outcomes and quality of life in patients operated transvaginally with an original mesh shape for uterus-sparing prolapse surgery and to demonstrate the safety and efficacy of the technique. Study design: We prospectively evaluated 66 postmenopausal patients (POP-Q Stage III: 32, IV: 34) operated between May 2008 and December 2013. We used wide weave polypropylene monofilament mesh that functions as a hammock anchored posteriorly to sacrospinous ligaments, its anterior wings exit the pelvis through the obturatory membrane. Follow-up was scheduled at 3-, 12-months and in May 2016. Prolapse-Quality of Life Questionnaire (P-QoL) was administered preoperatively, at 12 months and in May 2016. The chi square and Wilcoxon test were used for statistical analysis. Results: Mean follow-up was 5.6 (SD: 1.6, Range: 1.1-8.1) years. The overall success rate (POP-Q 2) was 92.5% at 12 months and 84.4% at May 2016, these data remained stable over time (p > 0.05). Early complications occurred in 2 (3%) patients, late in 5 (7.8%) of which mesh extrusion in 4 (6.3%). Data from P-QoL showed significant improvement between preoperative and postoperative data (P < 0.01 for all domains) and they remained stable with time (p > 0.05). De-novo dyspareunia was 17.6% at 12 months and 10.3% at May 2016. Conclusions: The low rate and grade of complications demonstrates the safety of the procedure, which offers stable anatomical correction with significant improvement in QoL.

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Section: Discussionsupporting

confidence: 90%

Long-term experience with a novel uterine-sparing transvaginal mesh procedure for uterovaginal prolapse

Nicita

Villari

Marzi

et al. 2018

European Journal of Obstetrics & Gynecology and Reproductiv

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“…19 Similar improvement was observed in other studies assessing female sexual functions, using FSFI after surgery for POP. 20,21 The current study had 54% postmenopausal women and improvement in sexual function occurred regardless menopause. This is in contrast with a study by Long et al who assessed the effect of TVM surgery on sexual function of both pre and postmenopausal women using FSFI.…”

Section: A H E a D O F P R I N Tmentioning

confidence: 78%

Surgery for pelvic organ prolapse and stress urinary incontinence and female sexual functions: A quasi-experimental study

2021

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Objectives: To assess the effect of pelvic organ prolapse (POP) and/or stress urinary incontinence (SUI) on various domains of female sexual functions in patients before and after reconstructive surgery for these pelvic floor disorders. Methods: We conducted a quasi-experimental study of 126 women aged 25-65 years, presenting with POP / SUI, from January 1st 2019 to December 31st 2019 at Aga Khan University Hospital. POP surgery was performed only in patients with symptomatic POP ≥ stage 2 according to POP-Q (quantification). Sexual functions were assessed using Female Sexual Function Index (FSFI) questionnaire, among sexually active women at baseline and 18 months after surgery. Results: Mean age of the participants was 51.6, with a mean parity of four. Out of 126 patients, 31 patients underwent vaginal hysterectomy, pelvic floor repair and mid-urethral sling (MUS), 55 had vaginal hysterectomy with pelvic floor repair, 12 women had only pelvic floor repair and 10 patients had uterine suspension surgery for prolapse, while 18 patients underwent MUS operation alone for SUI. There was a statistically significant difference in female sexual functions after surgery for POP and/or SUI (p<0.01). This improvement was observed in both total and individual scores of each domain of FSFI with an overall improvement in sexual function from a mean of 18.5 pre-surgery to 20.8 post-surgery. Conclusions: This study reveals that women sexual functions are affected by POP and SUI and improve remarkably after reconstructive surgeries for these pelvic floor disorders. doi: https://doi.org/10.12669/pjms.37.4.3892 How to cite this:Abrar S, Mohsin R, Saleem H. Surgery for pelvic organ prolapse and stress urinary incontinence and female sexual functions: A quasi-experimental study. Pak J Med Sci. 2021;37(4):---------. doi: https://doi.org/10.12669/pjms.37.4.3892 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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“…Previous research has not examined the effect of pessaries and pelvic floor physiotherapy on the specific outcome of deep dyspareunia, however these treatments are associated with increased frequency and satisfaction in sexual intercourse, and less inference of prolapse symptoms with sex life [38,40,41]. Minimally invasive or open repair for POP, with or without mesh, has not consistently been shown to decrease dyspareunia [42][43][44][45] and de novo dyspareunia after transvaginal mesh surgery may occur in a proportion of cases (4.5-27%) [46].…”

Section: Pelvic Organ Prolapsementioning

confidence: 99%

Deep Dyspareunia: Review of Pathophysiology and Proposed Future Research Priorities

Orr

Wahl

Joannou

et al. 2019

Sexual Medicine Reviews

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Introduction: Dyspareunia has been traditionally divided into superficial (introital) dyspareunia and deep dyspareunia (pain with deep penetration). While deep dyspareunia can co-exist with a variety of conditions, recent work in endometriosis has demonstrated that coexistence does not necessarily imply causation. Therefore, a reconsideration of the literature is required to clarify the pathophysiology of deep dyspareunia. Aims: To review the pathophysiology of deep dyspareunia, and to propose future research priorities. Methods: Narrative review after appraisal of published frameworks and literature search with the terms (dyspareunia AND endometriosis), (dyspareunia AND deep), (dyspareunia AND (pathophysiology OR etiology)). Main Outcome Variable: Deep dyspareunia (present/absent or along a pain severity scale). Results: Potential etiologies for deep dyspareunia include gynecological, urological, gastrointestinal, nervous system, psychological, and musculoskeletal system related. These etiologies can be classified according to anatomic mechanism (contact with a tender pouch of Douglas, uterus-cervix, bladder, or pelvic floor, with deep penetration). They can also be stratified into four categories (as previously proposed for endometriosis specifically), which can be utilized to personalize management: Type I (primarily gynecologic), Type II (nongynecologic comorbid conditions), Type III (central sensitization and genito-pelvic pain Page 1 of 49 penetration disorder), and Type IV (mixed). Sociocultural and genetic factors and sexual response may also be important for deep dyspareunia. Conclusion: We propose the following eight research priorities for deep dyspareunia: 1) development of deep dyspareunia measurement tools; 2) focus on the population who are avoiding intercourse due to deep dyspareunia; 3) clarification of the role of non-gynecologic comorbidities in the generation of deep dyspareunia; 4) addressing of ethnic and other sociocultural factors; 5) initiation of clinical trials with adequate power for deep dyspareunia outcomes; 6) inclusion of partner variables; 7) elucidation of pathways between psychological factors and deep dyspareunia; and 8) empirical validation of personalized approaches to deep dyspareunia.

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Analysis of changes in sexual function in women undergoing pelvic organ prolapse repair with abdominal or vaginal approaches

Abstract: Sexual function and pelvic floor symptoms improved in a similar manner in patients after abdominal and transvaginal POP surgery.

Cited by 22 publications

References 30 publications

Long-term experience with a novel uterine-sparing transvaginal mesh procedure for uterovaginal prolapse

Long-term experience with a novel uterine-sparing transvaginal mesh procedure for uterovaginal prolapse

Surgery for pelvic organ prolapse and stress urinary incontinence and female sexual functions: A quasi-experimental study

Deep Dyspareunia: Review of Pathophysiology and Proposed Future Research Priorities

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