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

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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.

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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

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Acknowledgement

The Authors would like to thank Dr Geraldine Boyd for editing this paper

Conflict of interest

None.

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Authors and Affiliations

  1. Department of Urology and Andrology, University of Perugia, S.M. Misericordia Hospital, S. Andrea delle Fratte, 06100, Perugia, Italy

    Elisabetta Costantini, Massimo Porena, Massimo Lazzeri, Luigi Mearini & Alessandro Zucchi

  2. Department of Internal Medicine, University of Perugia, Perugia, Italy

    Vittorio Bini

Authors
  1. Elisabetta Costantini
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  2. Massimo Porena
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  3. Massimo Lazzeri
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  4. Luigi Mearini
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  5. Vittorio Bini
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  6. Alessandro Zucchi
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Corresponding author

Correspondence to Alessandro Zucchi.

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Costantini, E., Porena, M., Lazzeri, M. et al. Changes in female sexual function after pelvic organ prolapse repair: role of hysterectomy. Int Urogynecol J 24, 1481–1487 (2013). https://doi.org/10.1007/s00192-012-2041-3

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  • DOI: https://doi.org/10.1007/s00192-012-2041-3

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