Changes in Sexual Function after Treatment for Prolapse Are Related to the Improvement in Body Image Perception

Abstract

Introduction In a previous study, sexual function was related to a woman’s self-perceived body image and degree of bother from pelvic organ prolapse (POP). Aims To evaluate sexual function, prolapse symptoms, and self-perceived body image 6 months following treatment for POP and to explore differences in body image perception and sexual function following conservative and surgical treatment for POP. Methods After institutional review board approval, consecutive women with ≥stage II POP were invited to participate. In addition to routine urogynecologic history and physical examination, including Pelvic Organ Prolapse Quantification (POP-Q), the participants completed three validated questionnaires before, and 6 months after, treatment for POP: Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire, Modified Body Image Perception Scale and Prolapse subscale of Pelvic Floor Distress Inventory to assess condition specific bother from POP. Main Outcome Measures Changes in sexual function and body image perception following treatment for POP. Results A total of 235 women with a mean age of 62 ± 12 years returned for a 6-month follow-up. The majority of our participants had surgical repair for POP (88%). At 6-month follow-up visits, the patients reported significant improvement in sexual function from baseline (33 ± 0.6 vs. 43 ± 0.8, respectively P < 0.0001). Improvement in sexual function, as measured by PISQ-12, was not significant among sexually active patients treated with a pessary compared with those treated surgically (–2.5 ± 5.5 vs. 11.5 ± 1, respectively P < 0.0001). A multivariate linear regression model demonstrated that body mass index and changes in body image perception were the only independent factors associated with changes in PISQ score following POP treatment (β = −0.5, P < 0.01 and β = −0.4, P < 0.03, respectively). Conclusions Resolution of POP symptoms after treatment improves women’s self-perceived body image and sexual function. Not surprisingly, pessary is less effective in improving sexual function compared with surgical repair of POP.

Sexual Function After Rectocele Repair

“…As there is a negative correlation between severity of prolapse, body image, and sexual function [21,22], we may speculate that due to the missing prolapsed symptoms and improved body image, particularly the domains desire and satisfaction are positively influenced.…”

Validation of a Chinese Version of the Short Form of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire

“…It appears to be useful for clinical evaluation of global and domain‐related sexual function. It can also be used in research settings as an overall rather than symptom‐specific assessment of sexual function, for example, in evaluating the impact of pelvic floor surgery on postoperative sexual function [12–14]. Evaluating sexual function may be particularly important for women who have undergone surgery and adjuvant therapy for gynecologic cancers.…”

Prolaps

“…Niet zozeer door de lichamelijke veranderingen, als wel door de psychische last die het hebben van een prolaps voor veel vrouwen betekent [16,17].Vrouwen die last hebben van urine-of fecale incontinentie tijdens seksuele activiteit, vermijden seksuele activiteit vaak, vanwege de angst of de schaamte die dit met zich meebrengt. Behandeling van de klachten kan leiden tot een positiever zelfbeeld, minder schaamtegevoel en daarmee ook een verbetering van het seksueel functioneren [18].…”