Sexual function and vaginal anatomy in women before and after surgery for pelvic organ prolapse and urinary incontinence

Weber, Anne M.; Walters, Mark D.; Piedmonte, Marion

doi:10.1067/mob.2000.107436

Cited by 295 publications

(225 citation statements)

References 13 publications

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“…Similarly, some investigators have reported that the surgical management of pelvic organ prolapse improves sexual function in the patients [14]. However, this positive effect of treatment has not been confirmed by all researchers [15,16].…”

Section: Discussionmentioning

confidence: 84%

Sexual function after suburethral sling removal for dyspareunia

et al. 2008

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Introduction Impact on sexual function has received little attention in the medical literature for a long time. Because of the site of insertion of permanent tension free vaginal tape (TVT) the G spot might be affected or the tape might interfere with arousal and sensory stimulation. Recent studies have reported varying degrees of sexual impairment after TVT insertion ranging from 0% to 15% including dyspareunia. Aim The aim of this study was to evaluate sexual function before and after suburethral sling removal due to postoperative female de novo dyspareunia. As a secondary outcome, general patients' satisfaction with their overall continence situation was assessed. Patients and methods Between December 2005 and December 2007, we included 18 female patients who complained of de novo dyspareunia after suburethral sling insertion for urinary stress incontinence. All patients filled in an FSFI questionnaire prior to sling removal and at 3 months postoperatively. Additionally, all women were asked to estimate their general satisfaction regarding their continence situation using a Visual Analogue Scale (VAS) from 0 to 10, with 0 being the least satisfying situation and 10 being the most satisfying situation. All patients underwent gynaecological examination including ICS-pelvic organ prolapse staging (ICS-POP score).Results Of the 18 slings, ten were transobturator tapes (6 9 TVT-O, 2 9 Monarch, 2 9 unknown) and eight were retropubic tapes (7 9 TVT, 1 9 SPARC). Desire, arousal, lubrication, satisfaction, and pain improved statistically significant. Orgasm scores were low with median scoring of 1.5 scores before and 1.0 scores after sling removal, and they did not change significantly after sling removal. The satisfaction rate deteriorated from a median of 7 (95% confidence interval [CI] 6.3-7.7) to a median of 4 (95% CI 3.7-5.1; p = 0.99) but not statistically significant. Conclusions Sexual function in patients with de novo dyspareuina is likely to improve after sling removal but not in all domains. Bladder function may deteriorate.

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Section: Discussionmentioning

confidence: 84%

Sexual function after suburethral sling removal for dyspareunia

et al. 2008

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“…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.…”

Section: Methodsmentioning

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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“…Much of the sparse data about sexual function in women with prolapse is limited by the use of non-validated outcome measures 6,8,9 . Some studies of the impact of surgical intervention have also been limited by an absence of baseline data 10 .…”

Section: Introductionmentioning

confidence: 99%

Sexual function before and after sacrocolpopexy for pelvic organ prolapse

Handa¹,

Zyczynski²,

Brubaker³

et al. 2007

American Journal of Obstetrics and Gynecology

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Objective-To describe sexual function before and after sacrocolpopexy.Study design-In the Colpopexy and Urinary Reduction Efforts trial, sexual function was assessed in 224 women with sexual partners before and 1 year after surgery using validated questionnaires.Corresponding Author: Victoria L. Handa, MD, Johns Hopkins Bayview Medical Center, 4940 Eastern Avenue, Baltimore, MD 21224, (410) 550-0335, Fax (410) 550-0196, Vhanda1@jhmi.edu. Reprints will not be available. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.Presented at the Thirty-Third Annual Meeting of the Society of Gynecologic Surgeons, Orlando, Florida, April 13, 2007.Condensation One year after sacrocolpopexy, more women were sexually active than before surgery and significantly fewer women report sexual interference from pelvic floor symptoms or dyspareunia. Results-After surgery, significantly fewer women reported sexual interference from "pelvic or vaginal symptoms" (32.5% one year after surgery versus 7.8% prior to surgery), fear of incontinence (10.7% versus 3.3%), vaginal bulging (47.3% versus 4.6%), or pain (39.9% versus 21.6%). The proportion of women with infrequent sexual desire (32%) did not change. More women were sexually active 1 year after surgery (171, 76.3%) than before surgery (148, 66.1%). The 11 women (7.4%) who became sexually inactive were more likely than sexually active women to report infrequent sexual desire (70.05% versus 22.1%, p<0.001). The addition of Burch colposuspension did not impact postoperative sexual function.Conclusions-After sacrocolpopexy, most women reported improvements in pelvic floor symptoms that previously interfered with sexual function. These improvements were not impacted by concomitant Burch colposuspension.

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Sexual function and vaginal anatomy in women before and after surgery for pelvic organ prolapse and urinary incontinence

Cited by 295 publications

References 13 publications

Sexual function after suburethral sling removal for dyspareunia

Sexual function after suburethral sling removal for dyspareunia

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

Sexual function before and after sacrocolpopexy for pelvic organ prolapse

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