International Urogynecology Journal

, Volume 24, Issue 9, pp 1481–1487

Changes in female sexual function after pelvic organ prolapse repair: role of hysterectomy

  • Elisabetta Costantini
  • Massimo Porena
  • Massimo Lazzeri
  • Luigi Mearini
  • Vittorio Bini
  • Alessandro Zucchi
Original Article

DOI: 10.1007/s00192-012-2041-3

Cite this article as:
Costantini, E., Porena, M., Lazzeri, M. et al. Int Urogynecol J (2013) 24: 1481. doi:10.1007/s00192-012-2041-3
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Abstract

Introduction and hypothesis

Incontinence and pelvic organ prolapse (POP) have an impact on sexuality. Few studies evaluate the impact of hysterectomy on sexual function. We designed the present observational prospective longitudinal cohort study in order to evaluate the impact of uterus preservation after POP repair on sexual function.

Methods

Between January 2006 and January 2011, 107 patients with POP, mean age 58 ± 8.9 years, underwent colposacropexy with or without hysterectomy. All the women without uterine disease were offered the chance to preserve the uterus. All patients gave written informed consent and completed the Female Sexual Function Index (FSFI) questionnaire, before and after surgery, provided detailed case history, underwent urogynaecological examination and urodynamic assessment and completed the Urogenital Distress Inventory short form (UDI-6) and Incontinence Impact on Quality of Life short form (IIQ-7) questionnaires, and the satisfaction Visual Analogue Scale (VAS). One year after surgery patients repeated the FSFI questionnaire and underwent a clinical check-up. The primary end-point was post-operative sexual function as evaluated by the FSFI, the secondary end-points were objective anatomical and subjective success, defined respectively as no prolapse and no incontinence-related symptoms.

Results

Sixty-eight patients were included: 32 underwent uterus-sparing surgery and 36 hysterectomy plus colposacropexy. After surgery both groups had significant improvements in the total FSFI score and in the domains of desire, arousal and orgasm. The median post-operative scores of desire, arousal, and orgasm domains showed significant improvements in the uterus-sparing group compared with the hysterectomy group. None of the women had a uterine or vault prolapse recurrence.

Conclusions

Our data demonstrate that POP plays a role in female sexual dysfunction and uterus sparing surgery is associated with a greater improvement in sexual function.

Keywords

POP surgeryFemale sexual dysfunctionFSFIHysterocolposacropexyUterus preservation

Abbreviations

FSD

Female sexual dysfunction

FSFI

Female Sexual Function Index

HSP

Hysterocolposacropexy

HY + CSP

Hysterectomy and colposacropexy

IIQ-7

Incontinence Impact on Quality of Life

POP

Pelvic organ prolapse

UDI-6

Urogenital Distress Inventory

VAS

Visual Analogue Scale

Copyright information

© The International Urogynecological Association 2013

Authors and Affiliations

  • Elisabetta Costantini
    • 1
  • Massimo Porena
    • 1
  • Massimo Lazzeri
    • 1
  • Luigi Mearini
    • 1
  • Vittorio Bini
    • 2
  • Alessandro Zucchi
    • 1
  1. 1.Department of Urology and AndrologyUniversity of Perugia, S.M. Misericordia Hospital, S. Andrea delle FrattePerugiaItaly
  2. 2.Department of Internal MedicineUniversity of PerugiaPerugiaItaly