Skip to main content

Urinary, Bowel and Sexual Symptoms After Surgery for Pelvic Organ Prolapse

  • Chapter
  • First Online:
Management of Pelvic Organ Prolapse

Abstract

The aim of this chapter is to provide evidence-based summary on the effect of surgical management of pelvic organ prolapse on urinary, bowel and sexual symptoms. Available literature is reviewed and analysed. Prolapse repair does not increase the risk of de novo stress urinary incontinence, which has the highest probability after surgery for apical compartment prolapse. For patients with coexistent prolapse and stress incontinence, there is no difference in postoperative outcome between combined or interval surgery, bearing in mind the higher morbidity of the combined approach. Preoperative overactive bladder and voiding symptoms usually improve after prolapse repair. Bowel symptoms tend to improve, especially if posterior repair is performed, though this carries a risk of de novo constipation. Whilst sexual function tends to improve after abdominal or laparoscopic repair of apical compartment prolapse, available evidence in relation to transvaginal mesh repair is conflicting. Patient-centred management and adequate pre-operative counselling are essential to ensure that patients’ expectations are realistic and improve their satisfaction.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 69.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 119.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Barber MD, Brubaker L, Nygaard I, Wheeler TL 2nd, Schaffer J, Chen Z, Spino C, Pelvic Floor Disorders Network. Defining success after surgery for pelvic organ prolapse. Obstet Gynecol. 2009;114:600–9.

    Article  Google Scholar 

  2. Maher C, Feiner B, Baessler K, Christmann-Schmid C, Haya N, Brown J. Surgery for women with anterior compartment prolapse. Cochrane Database Syst Rev. 2016;11:CD004014.

    PubMed  Google Scholar 

  3. Baessler K, Maher C. Pelvic organ prolapse surgery and bladder function. Int Urogynecol J. 2013;24:1843–52.

    Article  Google Scholar 

  4. Maher C, Feiner B, Baessler K, Christmann-Schmid C, Haya N, Brown J. Surgery for women with apical vaginal prolapse. Cochrane Database Syst Rev. 2016a;10:CD012376.

    PubMed  Google Scholar 

  5. van der Ploeg JM, van der Steen A, Oude Rengerink K, van der Vaart CH, Roovers JP. Prolapse surgery with or without stress incontinence surgery for pelvic organ prolapse: a systematic review and meta-analysis of randomised trials. BJOG. 2014;121:537–47.

    Article  Google Scholar 

  6. Maher C, Feiner B, Baessler K, Schmid C. Surgical management of pelvic organ prolapse in women. Cochrane Database Syst Rev. 2013;4:CD004014.

    Google Scholar 

  7. de Oliveira MS, Cavalcanti Gde A, da Costa AA. Native vaginal tissue repair for genital prolapse surgical treatment: a minimum of 30 months of results. Eur J Obstet Gynecol Reprod Biol. 2016;201:75–8.

    Article  Google Scholar 

  8. Dua A, Radley S, Brown S, Jha S, Jones G. The effect of posterior colporrhaphy on anorectal function. Int Urogynecol J. 2012;23:749–53.

    Article  Google Scholar 

  9. Siddiqui NY, Grimes CL, Casiano ER, Abed HT, Jeppson PC, Olivera CK, Sanses TV, Steinberg AC, South MM, Balk EM, Sung VW, Society of Gynecologic Surgeons Systematic Review Group. Mesh sacrocolpopexy compared with native tissue vaginal repair: a systematic review and meta-analysis. Obstet Gynecol. 2015;125:44–55.

    Article  Google Scholar 

  10. Grimes CL, Lukacz ES, Gantz MG, Warren LK, Brubaker L, Zyczynski HM, Richter HE, Jelovsek JE, Cundiff G, Fine P, Visco AG, Zhang M, Meikle S, NICHD Pelvic Floor Disorders Network. What happens to the posterior compartment and bowel symptoms after sacrocolpopexy? evaluation of 5-year outcomes from E-CARE. Female Pelvic Med Reconstr Surg. 2014;20:261–6.

    Article  Google Scholar 

  11. Edenfield AL, Levin PJ, Dieter AA, Wu JM, Siddiqui NY. Is postoperative bowel function related to posterior compartment prolapse repair? Female Pelvic Med Reconstr Surg. 2014;20:90–4.

    Article  Google Scholar 

  12. Crane AK, Geller EJ, Matthews CA. Outlet constipation 1 year after robotic sacrocolpopexy with and without concomitant posterior repair. South Med J. 2013;106:409–14.

    Article  Google Scholar 

  13. Gutman RE, Bradley CS, Ye W, Markland AD, Whitehead WE, Fitzgerald MP, Network PFD. Effects of colpocleisis on bowel symptoms among women with severe pelvic organ prolapse. Int Urogynecol J. 2010;21:461–6.

    Article  Google Scholar 

  14. Kammerer-Doak D. Assessment of sexual function in women with pelvic floor dysfunction. Int Urogynecol J. 2009;20(Suppl 1):S45–50.

    Article  Google Scholar 

  15. Karmakar D, Dwyer PL. Failure of expectations in vaginal surgery: lack of appropriate consent, goals and expectations of surgery. Curr Urol Rep. 2016;17:87.

    Article  Google Scholar 

  16. Petri E, Ashok K. Partner dyspareunia: a report of six cases. Int Urogynecol J. 2012;23:127–9.

    Article  Google Scholar 

  17. Jha S, Gray T. A systematic review and meta-analysis of the impact of native tissue repair for pelvic organ prolapse on sexual function. Int Urogynecol J. 2015;26:321–7.

    Article  Google Scholar 

  18. Rudnicki M, Laurikainen E, Pogosean R, Kinne I, Jakobsson U, Teleman P. A 3-year follow-up after anterior colporrhaphy compared with collagen-coated transvaginal mesh for anterior vaginal wall prolapse: a randomised controlled trial. BJOG. 2016;123:136–42.

    Article  CAS  Google Scholar 

  19. Dietz V, Maher C. Pelvic organ prolapse and sexual function. Int Urogynecol J. 2013;24:1853–7.

    Article  Google Scholar 

  20. Bjelic-Radisic V, Aigmueller T, Preyer O, Ralph G, Geiss I, Muller G, Riss P, Klug P, Konrad M, Wagner G, Medl M, Umek W, Lozano P, Tamussino K, Tammaa A, Austrian Urogynecology Working Group. Vaginal prolapse surgery with transvaginal mesh: results of the Austrian registry. Int Urogynecol J. 2014;25:1047–52.

    Article  CAS  Google Scholar 

  21. Pickett SD, Barenberg B, Quiroz LH, Shobeiri SA, O’Leary DE. The significant morbidity of removing pelvic mesh from multiple vaginal compartments. Obstet Gynecol. 2015;125:1418–22.

    Article  Google Scholar 

  22. Manonai J, Rostaminia G, Denson L, Shobeiri SA. Clinical and ultrasonographic study of patients presenting with transvaginal mesh complications. Neurourol Urodyn. 2016;35:407–11.

    Article  Google Scholar 

  23. Hokenstad ED, El-Nashar SA, Blandon RE, Occhino JA, Trabuco EC, Gebhart JB, Klingele CJ. Health-related quality of life and outcomes after surgical treatment of complications from vaginally placed mesh. Female Pelvic Med Reconstr Surg. 2015;21:176–80.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Ismail, S.I.M.F., Rizk, D.E.E. (2018). Urinary, Bowel and Sexual Symptoms After Surgery for Pelvic Organ Prolapse. In: Li Marzi, V., Serati, M. (eds) Management of Pelvic Organ Prolapse. Urodynamics, Neurourology and Pelvic Floor Dysfunctions. Springer, Cham. https://doi.org/10.1007/978-3-319-59195-7_14

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-59195-7_14

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-59194-0

  • Online ISBN: 978-3-319-59195-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics