Sexual Function is Related to Body Image Perception in Women with Pelvic Organ Prolapse

Abstract

Introduction A previous study demonstrated that women seeking treatment for advanced pelvic organ prolapsed (POP) reported decreased self-perceived body image and decreased quality of life. Aims To determine the relationship between: (i) sexual function and POP, (ii) self-perceived body image and POP; and (iii) sexual function and self-perceived body image in women with prolapse. Methods After IRB approval, consecutive women with POP stage II or greater presenting for urogynecologic care at one of eight academic medical centers in the United States were invited to participate. In addition to routine urogynecologic history and physical examination, including pelvic organ prolapse quantification (POPQ), consenting participants completed three validated questionnaires: Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) to assess sexual function; Modified Body Image Perception Scale (MBIS) to assess self-perceived body image; Prolapse subscale of Pelvic Floor Distress Inventory (POPDI-6) to assess condition specific bother from POP. Pearson’s correlations were used to investigate the relationship between independent variables. Main Outcome Measures Sexual function and modified body image score and its correlation with symptoms of POP. Results Three hundred eighty-four participants with a mean age of 62 ± 12 years were enrolled. Median POPQ stage was 3 (range 2–4). 62% (N = 241) were sexually active and 77% (N = 304) were post-menopausal. Mean PISQ-12, MBIS, and POPDI scores were (33 ± 7, 6 ± 5, 39 ± 23, respectively). PISQ-12 scores were not related to stage or compartment (anterior, apical, or posterior) of POP (P > 0.5). Worse sexual function (lower PSIQ-12 scores) correlated with lower body image perception (higher MBIS scores) (rho = −0.39, P < 0001) and more bothersome POP (higher POPDI scores) (rho = −0.34, P < 0001). Conclusions Sexual function is related to a woman’s self-perceived body image and degree of bother from POP regardless of vaginal topography. Sexual function may be more related to a woman’s perception of her body image than to actual topographical changes from POP.

Impact of gynecological surgery on female sexual function

“…Urinary incontinence and pelvic organ prolapse can impact sexual function through a variety of means, including embarrassment of leakage with intercourse, coexisting depression and discomfort or low body image. [5][6][7] In spite of this, corresponding enhancement of sexual function has not been noted consistently after surgical correction of the preexisting problem. Deterioration in sexual symptoms may occur following repair.…”

Sexual function in older women with pelvic floor symptoms: a cross-sectional study in general practice

“…8,9 In the study population, having had pelvic floor surgery was related to poor sexual functioning. From previous studies, it is known that improvement or deterioration of sexual function after surgery seems to depend on the surgical technique used.…”

“…7 However, the evidence on the relationship between pelvic floor symptoms and sexual function remains conflicting. [10][11][12][13] Research in general practice is scarce, and it is difficult to extrapolate evidence from research performed in urogynaecology clinics 3,[7][8][9] to general practice, since women presenting at these clinics may be a selection of women with more severe symptoms.…”

“…6 More than one-third of sexually active women with an advanced prolapse indicate that their sexuality is affected by prolapse symptoms, 7 and experiencing more pelvic floor symptoms is associated with poorer sexual function. 8,9 Embarrassment or discomfort, resulting from prolapse or urinary incontinence, can result in sexual inactivity. 7 However, the evidence on the relationship between pelvic floor symptoms and sexual function remains conflicting.…”

The Fellows’ Pelvic Research Network (FPRN) 5 years later: an update

“…Over the past 3 years the network has published eight papers in peer-reviewed journals [1][2][3][4][5][6][7][8], and a further three manuscripts have been submitted for consideration for publication. In addition, the members of the network have actively participated in scientific conferences and presented nine of their studies as podium and poster presentations.…”