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Female sexual function and quality of life after pelvic floor surgery: a prospective observational study

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Abstract

Introduction and hypothesis

Knowledge about the impact of pelvic floor surgery on sexual function is limited and inconsistent. A prospective study assessed the impact of surgery for prolapse (POP) or stress urinary incontinence (SUI) on sexual function and determined the biopsychosocial predictors for changes in sexual function after surgery.

Materials and methods

Sexually active women scheduled for correction of POP and/or SUI were recruited over a 6-month period. Consenting participants were asked to complete the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) to evaluate sexual function. The King’s Health Questionnaire and Prolapse Quality-of-Life Questionnaire were used to assess UI and POP symptoms and their impact on quality of life (QoL), respectively. Women were reviewed over a period of 1 year post-surgery.

Results

Ninety-one patients were followed up over 1 year. After stratification into only or both SUI and POP surgery, global sexual function improved significantly in each group (p < 0.001). The improvement in the overall QoL score after pelvic surgery showed a significant correlation with the improvement in global sexual function (SUI group: r = – 0.38, p < 0.01; POP group: r = – 0.44, p < 0.05). For women undergoing SUI surgery, only educational level and prior hysterectomy had a significant association with improved sexual function. For women undergoing POP surgery with or without SUI surgical repair, no sociodemographic characteristics were preditive of improvement of sexual function.

Conclusions

Significantly improved sexual function was observed 1 year after pelvic floor surgery, and the improvement was predicted by other social and physical factors in addition to normal functional anatomy.

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Abbreviations

FSF:

Female sexual function

KHQ:

King’s Health Questionnaire

PFD:

Pelvic floor dysfunction

PISQ-12:

Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire

POP:

Pelvic organ prolapse

P-QoL:

Prolapse Quality-of-Life Questionnaire

QoL:

Quality of life

SUI:

Stress urinary incontinence

UI:

Urinary incontinence

References

  1. Jha S. Maintaining sexual function after pelvic floor surgery. Climacteric. 2019;22(3):236–41. https://doi.org/10.1080/13697137.2018.1551870.

    Article  CAS  PubMed  Google Scholar 

  2. Bicudo-Fürst MC, Borba Leite PH, Araújo Glina FP, Baccaglini W, de Carvalho Fürst RV, et al. Female sexual function following surgical treatment of stress urinary incontinence: systematic review and meta-analysis. Sex Med Rev. 2018;6(2):224–33. https://doi.org/10.1016/j.sxmr.2017.10.005.

    Article  PubMed  Google Scholar 

  3. Zawodnik A, Balaphas A, Buchs NC, Zufferey G, Robert-Yap J, et al. Does surgical approach in pelvic floor repair impact sexual function in women? Sex Med. 2019;7(4):522–9. https://doi.org/10.1016/j.esxm.2019.08.004.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Rantell A, Srikrishna S, Robinson D. Assessment of the impact of urogenital prolapse on sexual dysfunction. Maturitas. 2016;92:56–60. https://doi.org/10.1016/j.maturitas.2016.07.001.

    Article  PubMed  Google Scholar 

  5. Abrams P, Cardozo L, Wagg A, Wein A (2017). Incontinence, 6th Edition. International Continence Society, Bristol UK.

  6. Rogers RG, Pauls RN, Thakar R, Morin M, Kuhn A et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for the assessment of sexual health of women with pelvic floor dysfunction. Neurourol Urodyn. 2018. https://doi.org/10.1002/nau.23508.

  7. Knoepp LR, Shippey SH, Chen CC, et al. Sexual complaints, pelvic floor symptoms, and sexual distress in women over forty. J Sex Med. 2010;7:3675–82.

    Article  Google Scholar 

  8. Mestre M, Lleberia J, Pubill J, Espuña-Pons M. Los cuestionarios en la evaluación de la actividad y función sexual en mujeres con incontinência urinaria y prolpaso de órganos pélvicos. Actas Urol Esp. 2014.

  9. Neill C, Abdel-Fattah M, Ramsay IN. Sexual function and vaginal surgery. Obstet Gynaecol. 2009;11:193–8.

    Google Scholar 

  10. Santana GWRM, Aoki T, Auge APF. The Portuguese validation of the short form of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12). Int Urogynecol J. 2012. https://doi.org/10.1007/s00192-011-1505-1.

  11. Viana R, Viana S, Neto F, Mascarenhas T. Adaptation and validation of the King’s Health Questionnaire in Portuguese women with urinary incontinence. Int Urogynecol J. 2015. https://doi.org/10.1007/s00192-015-2628-6.

  12. de Oliveira MS, Tamanini JTN, de Aguiar Cavalcant G. Validation of the Prolapse Quality-of-Life Questionnaire (P-QoL) in Portuguese version in Brazilian women. Int Urogynecol J. 2009. https://doi.org/10.1007/s00192-009-0934-6.

  13. Verbeek M, Hayward L. Pelvic floor dysfunction and its effect on quality of sexual life. Sex Med Rev. 2019. https://doi.org/10.1016/j.sxmr.2019.05.007.

    Article  PubMed  Google Scholar 

  14. Srikrishna S, Robinson D, Cardozo L, Gonzalez J. Can sex survive pelvic floor surgery? Int Urogynecol J. 2010. https://doi.org/10.1007/s00192-010-1198-x.

    Article  PubMed  Google Scholar 

  15. Tyagi V, Perera M, Guerrero K, Hagen S, Pringle S. Prospective observational study of the impact of vaginal surgery (pelvic organ prolapse with or without urinary incontinence) on female sexual function. IntUrogynecol J. 2018. https://doi.org/10.1007/s00192-017-3500-7.

    Article  Google Scholar 

  16. Lonnée-Hoffmann RAM, Salvesen Ø, Mørkved S, Schei B. What predicts improvement of sexual function after pelvic floor surgery? A follow-up study. Acta Obstet Gynecol Scand. 2013. https://doi.org/10.1111/aogs.12237

  17. Celik DB, Beji NK, Yalcin O. Sexual function in women after urinary incontinence and/or pelvic organ prolapse surgery. J Clin Nurs. 2013. https://doi.org/10.1111/jocn.12496

  18. Roos AM, Thakar R, Sultan AH, de Leeuw JW, Paulus ATG. The impact of pelvic floor surgery on female sexual function: a mixed quantitative and qualitative study. BJOG. 2014. https://doi.org/10.1111/1471-0528.12412.

    Article  PubMed  Google Scholar 

  19. Szell N, Komisaruk B, Goldstein SW, Qu X, Shaw M, et al. A meta-analysis detailing overall sexual function and orgasmic function in women undergoing midurethral sling surgery for stress incontinence. Sex Med. 2017. https://doi.org/10.1016/j.esxm.2016.12.001

  20. Clark SMG, Huang Q, Sima AP, Siff LN. Effect of surgery for stress incontinence on female sexual function. ObstetGynecol. 2020;135(2):352–60. https://doi.org/10.1097/AOG.0000000000003648.

    Article  Google Scholar 

  21. Moore CK. The impact of urinary incontinence and its treatment on female sexual function. CurrUrol Rep. 2010. https://doi.org/10.1007/s11934-010-0124-6.

    Article  Google Scholar 

  22. Luz R, Pereira I, Henriques A, Ribeirinho AL,Valentim-Lourenço A. King's health questionnaire to assess subjective outcomes after surgical treatment for urinary incontinence: can it be useful?. Int Urogynecol J. 2017. https://doi.org/10.1007/s00192-016-3089-2

  23. Jha S, Ammenbal M, Metwally M. Impact of incontinence surgery on sexual function: a systematic review and meta-analysis. J Sex Med. 2012. https://doi.org/10.1111/j.1743-6109.2011.02366.x.

    Article  PubMed  Google Scholar 

  24. Bicudo-Fürst MC, Borba Leite PH, Araújo Glina FP, Baccaglini W, de Carvalho Fürst RV, Bezerra CA, Glina S. Female Sexual function following surgical treatment of stress urinary incontinence: systematic review and meta-analysis. Sex Med Rev. 2018;6(2):224–33. https://doi.org/10.1016/j.sxmr.2017.10.005.

    Article  PubMed  Google Scholar 

  25. Thompson JC, Rogers RG. Surgical management for pelvic organ prolapse and its impact on sexual function. Sex Med Rev. 2016. https://doi.org/10.1016/j.sxmr.2016.02.002

  26. 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. https://doi.org/10.1007/s00192-014-2518-3.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Glavind K, Larsen T, Lindquist AS. Sexual function in women before and after surgery for pelvic organ prolapse. Acta Obstet Gynecol Scand. 2015. https://doi.org/10.1111/aogs.12524.

    Article  PubMed  Google Scholar 

  28. Azar M, Noohi S, Radfar S, Radfar MH. Sexual function in women after surgery for pelvic organ prolapse. Int Urogynecol J Pelvic Floor Dysfunct. 2008. https://doi.org/10.1007/s00192-007-0399-4.

  29. Doganay M, Kokanalı D, Kokanalı MK, Cavkaytar S, Aksakal OS. Comparison of female sexual function in women who underwent abdominal or vaginal hysterectomy with or without bilateral salpingo-oophorectomy. J Gynecol Obstet Hum Reprod. 2018. https://doi.org/10.1016/j.jogoh.2018.11.004.

  30. Shahhosseini Z, HamzehGardeshi Z, Pourasghar M, Salehi F. A review of affecting factors on sexual satisfaction in women. Mater Sociomed. 2014;26(6):378–81.

    Article  Google Scholar 

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Funding

This study was financed by the annual prize of the Portuguese Society of Gynecology.

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Authors and Affiliations

  1. Faculty of Medicine, University of Coimbra, Azinhaga de Santa Comba, 3000-354, Coimbra, Portugal

    Ângela Rodrigues

  2. Clinical Academic Centre of Coimbra, Coimbra, Portugal

    Ângela Rodrigues

  3. Gynaecology Department, Coimbra Hospital and University Centre, Coimbra, Portugal

    Ângela Rodrigues, Carla Rodrigues, Liana Negrão & Maria Geraldina Castro

  4. Centre for Research and Development in Mathematics and Applications-CIDMA, Department of Mathematics, University of Aveiro, Aveiro, Portugal

    Vera Afreixo

Authors
  1. Ângela Rodrigues
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  2. Carla Rodrigues
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  3. Liana Negrão
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  4. Vera Afreixo
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  5. Maria Geraldina Castro
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Contributions

A Rodrigues: Project development, data collection, data analysis, manuscript writing

C Rodrigues: Project development, data collection, manuscript writing

L Negrão: Project development

V Afreixo: Data analysis

MG Castro: Project development, data collection, manuscript writing

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Correspondence to Ângela Rodrigues.

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Rodrigues, Â., Rodrigues, C., Negrão, L. et al. Female sexual function and quality of life after pelvic floor surgery: a prospective observational study. Int Urogynecol J 32, 1273–1283 (2021). https://doi.org/10.1007/s00192-021-04678-1

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  • DOI: https://doi.org/10.1007/s00192-021-04678-1

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