Sexual function in women before and after transvaginal mesh repair for pelvic organ prolapse

Abstract

The aim of the study was to assess sexual function in women before and after surgery with transvaginal mesh for pelvic organ prolapse. Women were invited to complete a sexual function questionnaire including the Lemack and the Pelvic Organ Prolapse Urinary Incontinence Sexual Questionnaires (PISQ-12) before undergoing surgery and 1 year after surgery. Eighty-three complete pre and postoperative questionnaires were analyzed. Mean age was 65.1 years. Forty-six were sexually inactive and 37 were sexually active women. Two sexually active women completed the preoperative PISQ-12 questionnaire retrospectively after surgery. There were no significant differences after surgery in the answers to the Lemack questionnaire and PISQ-12 scores. These results suggest that nonabsorbable transvaginal mesh repair of genital prolapse does not impair sexual function 1 year after surgery. Nevertheless, patients should not necessarily expect a significant improvement in sexual function outcome following transvaginal mesh repair for genital prolapse.

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References

  1. 1.

    Suback LL, Waetjen LE, Van den Eeden S, Thom DH, Vittinghoff E, Brown JS (2001) Cost of pelvic organ prolapse surgery in the United States. Obstet Gynecol 98:646–651

    Google Scholar 

  2. 2.

    Olsen AL, Smith VJ, Bergstrom JO, Colling JC, Clark AL (1997) Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol 89:501–506

    PubMed  Google Scholar 

  3. 3.

    Milani R, Salvatore S, Soligo M, Pifarotti P, Meschia M, Cortese M (2005) Functional and anatomical outcome of anterior and posterior vaginal prolapse repair with prolene mesh. BJOG 112:107–111

    PubMed  Google Scholar 

  4. 4.

    Dwyer PL, O’Reilly BA (2004) Transvaginal repair of anterior and posterior compartment prolapse with atrium polypropylene mesh. BJOG 111:831–836

    PubMed  Google Scholar 

  5. 5.

    Shah DK, Paul EL, Rastinehad AR, Eisenberg ER, Badlani GH (2004) Short-term outcome analysis of total pelvic reconstruction with mesh: the vaginal approach. J Urol 171:261–263

    PubMed  Article  Google Scholar 

  6. 6.

    Sentilhes L, Sergent F, Resch B, Verspyck E, Descamps P, Marpeau L (2007) Mid-term follow-up of high-grade genital prolapse repair by the trans-obturator and infracoccygeal hammock procedure after hysterectomy. Eur Urol 51:1065–1072

    PubMed  Article  Google Scholar 

  7. 7.

    Tunuguntla HS, Gousse AE (2006) Female sexual dysfunction following vaginal surgery: a review. J Urol 175:439–446

    PubMed  Article  Google Scholar 

  8. 8.

    Rogers RG, Kammerer-Doak D, Darrow A, Murray K, Qualls C, Olsen A, Barber M (2006) Does sexual function change after surgery for stress urinary incontinence and/or pelvic organ prolapse? A multicenter prospective study. Am J Obstet Gynecol 195:e1–e4

    PubMed  Article  Google Scholar 

  9. 9.

    Barber MD, Vusci AG, Wyman JF, Fantl JA, Bump RC (2002) Sexual function in women with urinary incontinence and pelvic organ prolapse. Obstet Gynecol 99:281–289

    PubMed  Article  Google Scholar 

  10. 10.

    Yucel S, De Souza A Jr, Baskin LS (2004) Neuroanatomy of the human female lower urogenital tract. J Urol 172:191–195

    PubMed  Google Scholar 

  11. 11.

    Salonia A, Briganti A, Deho F, Zanni G, Rigatti P, Montorsi F (2006) Women's sexual dysfunction: a review of the “surgical landscape”. Eur Urol 50:44–52

    PubMed  Article  Google Scholar 

  12. 12.

    Vardi Y (2006) Female sexual dysfunction after pelvic surgery: is there a place for nerve-sparing surgery?. Eur Urol 50:14–16

    PubMed  Article  Google Scholar 

  13. 13.

    Weber AM, Walters MD, Piedmonte MR (2000) Sexual function and vaginal anatomy in women before and after surgery for pelvic organ prolapse and urinary incontinence. Am J Obstet Gynecol 182:1610–1615

    PubMed  Article  Google Scholar 

  14. 14.

    Bump RC, Mattiasson A, Bo K, Brubaker LP, DeLancey JL, Klarskov P et al (1996) The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol 175:10–17

    PubMed  Google Scholar 

  15. 15.

    Sentilhes L, Sergent F, Resch B, Berthier A, Verspyck E, Marpeau L (2006) Posthysterectomy posterior compartment prolapse: preliminary results of a novel transvaginal surgical procedure using polypropylene mesh via the low transobturator route. Ann Chir 131:533–539

    PubMed  Article  Google Scholar 

  16. 16.

    Sergent F, Resch B, Diguet A, Verspyck E, Marpeau L (2006) Vaginal prolapse and stress urinary incontinence: combined treatment by a single prosthesis. Prog Urol 16:361–367

    PubMed  Google Scholar 

  17. 17.

    Cosson M, Debodinance M, Boukerrou M, Chauvet MP, Crepin G, Ego A (2003) Mechanical properties of synthetic implants used in the repair of prolapse and urinary incontinence in patients: which is the ideal material? Int Urogynecol J 14:169–178

    Google Scholar 

  18. 18.

    Collinet P, Deruelle P, Lucot JP, Cosson M (2005) Perineal cellulitis following trans-obturator sub-urethral tape Uratape. Eur Urol 47:108–110

    PubMed  Google Scholar 

  19. 19.

    Lemack GE, Zimmern PE (2000) Sexual function after vaginal surgery for stress incontinence: results of a mailed questionnaire. Urology 56:223–227

    PubMed  Google Scholar 

  20. 20.

    Rogers RG, Coates KW, Kammerer-Doak DN, Khalsa S, Qualls C (2003) A short form of the pelvic organ prolapse–urinary incontinence sexual questionnaire (PISQ-12). Int Urogynecol J Pelvic Floor Dysfunct 14:164–168

    PubMed  Article  Google Scholar 

  21. 21.

    Benhaim Y, de Tayrac R, Deffieux X, Gervaise A, Chauveaud-Lambling A, Frydman R, Fernandez H (2006) Treatment of genital prolapse with a polypropylene mesh inserted via the vaginal route. Anatomic and functional outcome in women aged less than 50 years. J Gynecol Obstet Biol Reprod 35:219–226

    Google Scholar 

  22. 22.

    Petros PE (2001) Vault prolapse II: restoration of dynamic vaginal supports by infracoccygeal sacropexy, an axial day-case vaginal procedure. Int Urogynecol J Pelvic Floor Dysfunct 12:296–303

    PubMed  Article  CAS  Google Scholar 

  23. 23.

    Sentilhes L, Sergent F, Marpeau L, Descamps P (2007) Should intravaginal slingplasty (IVS) procedure be abandoned? Am J Obstet Gynecol 196:e18

    PubMed  Article  Google Scholar 

  24. 24.

    Black NA, Bowling A, Griffiths JM, Pope C, Abel PD (1998) Impact of surgery for stress incontinence on the social lives of women. BJOG 105:605–612

    Google Scholar 

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Acknowledgement

Our sincere thanks to our patients who took the time to complete these questionnaires and to Richard Medeiros, Rouen University Hospital Medical Editor, for his valuable editorial assistance.

Funding

The authors confirm that they have no direct or indirect commercial financial incentive associated with publishing the article and that the source of extra-institutional funding, particularly that provided by commercial sources, is indicated.

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Correspondence to Loïc Sentilhes.

Appendix

Appendix

Pelvic Organ Prolapse Urinary Incontinence Sexual Function Questionnaire

(PISQ-12) [20]

Instructions: Following are a list of questions about you and your partner’s sex life. All information is strictly confidential. Your confidential answers will be used only to help doctors understand what is important to patients about their sex lives. Please check the box that best answers the question for you. While answering the questions, consider your sexuality over the past 6 months. Thank you for your help.

Scoring:

Scores are calculated by totaling the scores for each question with 0=always, 4=never. Reverse scoring is used for items 1, 2, 3, and 4. The short-form questionnaire can be used with up to two missing responses. To handle missing values, the sum is calculated by multiplying the number of items by the mean of the answered items. If there are more than two missing responses, the short form no longer accurately predicts long-form scores. To make scores comparable to long-form scores, multiply the total by 2.58 (31/12).

Lemack Questionnaire [19]

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Sentilhes, L., Berthier, A., Sergent, F. et al. Sexual function in women before and after transvaginal mesh repair for pelvic organ prolapse. Int Urogynecol J 19, 763–772 (2008). https://doi.org/10.1007/s00192-007-0521-7

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Keywords

  • Sexual function
  • Pelvic organ prolapse
  • Urinary incontinence
  • Dyspareunia
  • Mesh