Skip to main content

Advertisement

SpringerLink
Log in

Female sexuality before and after sacrocolpopexy or vaginal mesh: is vaginal length one of the key factors?

  • Original Article
  • Published:
International Urogynecology Journal Aims and scope Submit manuscript

Abstract

Introduction and hypothesis

We aimed to demonstrate that laparoscopic sacrocolpopexy/cervicopexy (LSC-Cx) versus anterior vaginal mesh (AVM) results in a longer vaginal length without impacting sexual activity or function.

Methods

We performed a secondary analysis of sexual outcomes of a previous randomized control trial comparing LSC-Cx and AVM in 120 women (60/group) with symptomatic POP stage ≥ 3. We evaluated sexually active (SA) and non-sexually active women (NSA) using the Pelvic Organ Prolapse/Incontinence Sexual Questionnaire-IUGA-Revised (PISQ-IR) preoperatively and 1 year postoperatively. Multivariate logistic and linear regression models were built to assess the impact of different variables on sexual activity and function, respectively.

Results

Among 120 women included, no statistically significant differences were found between vaginal length and preoperative dyspareunia (20.7% AVM vs. 22,8% LSC-Cx) comparing SA to NSA women and LSC-Cx to AVM. Vaginal length was significantly longer after LSC-Cx versus AVM (p < 0.001). The postoperative dyspareunia rate was 17.2% AVM versus 10.5% LSC-Cx. Partnered women were significantly more likely to be SA than unpartnered women before (OR = 19.04; p = 0.006) and after surgery (OR = 36.28; p = 0.002). Only dyspareunia was independently associated with sexual function pre- (B = −0.431; p = 0.017) and postoperatively (B = −0.3 96; p = 0.007).

Conclusions

Vaginal length was greater following LSC-Cx compared to AVM. While vaginal length has no impact on female sexuality pre- and postoperatively, the most important factors were “having a partner” for sexual activity and dyspareunia for sexual function. Persistence of dyspareunia was higher after AVM. LSC-Cx should be considered in women with POP undergoing mesh surgery with future sexual expectations.

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

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Glazener CM, Breeman S, Elders A, et al. Mesh, graft, or standard repair for women having primary transvaginal anterior or posterior compartment prolapse surgery: two parallel-group, multicentre, randomised, controlled trials (PROSPECT). Lancet. 2016;389(10067):381–92. https://doi.org/10.1016/S0140-6736(16)31596-3.

    Article  PubMed  Google Scholar 

  2. Maher C, Feiner B, Baessler K, Christmann-Schmid C, Haya N, Marjoribanks J. Transvaginal mesh or grafts compared with native tissue repair for vaginal prolapse. The Cochrane data base of systematic reviews. 2016;2:CD012079. https://doi.org/10.1002/14651858.CD012079.

    Article  Google Scholar 

  3. Bataller E, Ros C, Anglès S, et al. Anatomical outcomes 1 year after pelvic organ prolapse surgery in patients with and without a uterus at a high risk of recurrence: a randomised controlled trial comparing laparoscopic sacrocolpopexy/cervicopexy and anterior vaginal mesh. Int Urogynecol J. 2019;30:545. https://doi.org/10.1007/s00192-018-3702-7.

    Article  PubMed  Google Scholar 

  4. Lucot JP, Cosson M, Bader G, et al. Safety of Vaginal vaginal mesh surgery versus laparoscopic mesh sacropexy for cystocele repair: results of the Prosthetic Pelvic Floor Repair (PROSPERE) Randomized Controlled Trial. Eur Urol. 2018;74(2):167–76. https://doi.org/10.1016/j.eururo.2018.01.044.

    Article  PubMed  Google Scholar 

  5. Gutman RE, Rardin CR, Sokol E, et al. Vaginal and laparoscopic mesh hysteropexy for uterovaginal prolapse: a parallel cohort study. Am J Obstet Gynecol. 2017;216(1):38.e1–38.e11. https://doi.org/10.1016/j.ajog.2016.08.035.

    Article  Google Scholar 

  6. Zhang CY, Sun ZJ, Yang J, Xu T, Zhu L, Lang JH. Sacrocolpopexy compared with transvaginal mesh surgery: a systematic review and meta-analysis. BJOG. 2020. https://doi.org/10.1111/1471-0528.16324.

  7. Anglès-Acedo S, Ros-Cerro C, Escura-Sancho S, Palau-Pascual MJ, Bataller-Sánchez E, Espuña-Pons M, et al. Sexual activity and function in women with advanced stages of pelvic organ prolapse, before and after laparoscopic or vaginal mesh surgery. Int Urogynecol J. 2020. https://doi.org/10.1007/s00192-020-04406-1.

  8. Mestre M, Lleberia J, Pubill J, Espuna-Pons M. Spanish version of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire IUGA-Revised (PISQ-IR): Transcultural validation. Int Urogynecol J. 2017;28:1865–73. https://doi.org/10.1007/s00192-017-3312-9.

    Article  PubMed  Google Scholar 

  9. Constantine ML, Pauls RN, Rogers RR, Rockwood TH. Validation of a single summary score for the prolapse/Incontinence sexual questionnaire–IUGA revised (PISQ-IR). Int Urogynecol J. 2017;28(12):1901–7. https://doi.org/10.1007/s00192-017-3373-9.

    Article  PubMed  Google Scholar 

  10. Sanchez-Sanchez B, Torres-Lacomba M, Yuste-Sanchez MJ, et al. Cultural adaptation and validation of the Pelvic Floor Distress Inventory short form (PFDI-20) and Pelvic Floor Impact Questionnaire short form (PFIQ-7) Spanish versions. Eur J ObstetGynecolReprodBiol. 2013;170:281–5. https://doi.org/10.1016/j.ejogrb.2013.07.006.

    Article  Google Scholar 

  11. De La Cruz JF, Myers EM, Geller EJ. Vaginal versus robotic hysterectomy and concomitant pelvic support surgery: a comparison of postoperative vaginal length and sexual function. J Minim Invasive Gynecol. 2014;21:1010–4.

    Article  Google Scholar 

  12. Uçar MG, et al. Sexual functioning before and after vaginal hysterectomy to treat pelvic organ prolapse and the effects of vaginal cuff closure techniques: a prospective randomised study. Eur J Obstetrics Gynecol Reprod Biol. 206:1–5.

  13. Weber AM, Walters MD, Piedmonte MR. Sexual function and vaginal anatomy in women before and after surgery for pelvic organ prolapse and urinary incontinence. Am J Obstet Gynecol. 2000;182:1610–5.

    Article  CAS  Google Scholar 

  14. Edenfield AL, Levin PJ, Dieter AA, Amundsen CL, Siddiqui NY. Sexual activity and vaginal topography in women with symptomatic pelvic floor disorders. J Sex Med. 2015;12:416–23.

    Article  Google Scholar 

  15. Siff LN, Barber MD, Zyczynski HM, Rardin CR, Jakus-Waldman S, Rahn DD, et al. NICHD pelvic floor disorders network immediate postoperative pelvic organ prolapse quantification measures and 2-year risk of prolapse recurrence. Obstet Gynecol. 2020;136(4):792–801. https://doi.org/10.1097/AOG.0000000000004043.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Ellibeş Kaya A, Doğan O, Yassa M, Başbuğ A, Özcan C, Çalışkan E. Do external female genital measurements affect genital perception and sexual function and orgasm? Turk J Obstet Gynecol. 2020;17(3):175–81. https://doi.org/10.4274/tjod.galenos.2020.89896.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Lowenstein L, Gamble T, Sanses TV, van Raalte H, Carberry C, Jakus S, et al. Sexual function is related to body image perception in women with pelvic organ prolapse. J Sex Med. 2009;6:2286–91.

    Article  Google Scholar 

  18. Sung VW, Rogers RG, Barber MD, Clark MA. Conceptual framework for patient-important treatment outcomes for pelvic organ prolapse. Neurourol Urodyn. 2014;33(4):414–9. https://doi.org/10.1002/nau.22397.

    Article  PubMed  Google Scholar 

  19. Lowenstein L, Gamble T, Sanses TV, van Raalte H, Carberry C, Jakus S, Pham T, Nguyen A, Hoskey K, Kenton K; Fellow’s pelvic research network. Changes in sexual function after treatment for prolapse are related to the improvement in body image perception. J Sex Med 2010;7(2 Pt 2):1023-1028. https://doi.org/10.1111/j.1743-6109.2009.01586.x

  20. Lowder JL, Ghetti C, Moalli P, Zyczynski H, Cash TF. Body image in women before and after reconstructive surgery for pelvic organ prolapse. Int Urogynecol J. 2010;21(8):919–25. https://doi.org/10.1007/s00192-010-1141-1.

    Article  PubMed  Google Scholar 

  21. Antosh DD, Kim-Fine S, Meriwether KV, Kanter G, Dieter AA, Mamik MM, et al. Changes in sexual activity and function after pelvic organ prolapse surgery: a systematic review. Obstet Gynecol. 2020;136(5):922–31. https://doi.org/10.1097/AOG.0000000000004125.

    Article  PubMed  Google Scholar 

  22. Gupta P, Payne J, Killinger KA, et al. Analysis of changes in sexual function in women undergoing pelvic organ prolapse repair with abdominal or vaginal approaches. Int Urogynecol J. 2016;27:1919. https://doi.org/10.1007/s00192-016-3066-9.

    Article  PubMed  Google Scholar 

  23. Maher C, Baessler K, Barber M, Cheon C, Consten E, Cooper K, et al (2016) Pelvic organ prolapse surgery. In: Incontinence Abrams P, Cardozo L, Wagg A, Wein A, editors. International consultation on Incontinence, 6th edition, Tokyo; pp. 1855-1991. ISBN: 978-0-9569607-3-3.

Download references

Acknowledgements

We thank Dr. Emilia Sánchez for her contribution to the statistical analyses.

Funding

The Elevate® Anterior and Apical kits were donated by AMS as a grant for the study without any other support or supervision.

Author information

Authors and Affiliations

  1. Pelvic Floor Unit, ICGON, Hospital Clínic de Barcelona, University of Barcelona, Villarroel 170, 08036, Barcelona, Spain

    Sònia Anglès-Acedo, Cristina Ros-Cerro, Sílvia Escura-Sancho, M. José Palau-Pascual, Eduardo Bataller-Sánchez, Montserrat Espuña-Pons & Francisco Carmona-Herrera

Authors
  1. Sònia Anglès-Acedo
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Cristina Ros-Cerro
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sílvia Escura-Sancho
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M. José Palau-Pascual
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Eduardo Bataller-Sánchez
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Montserrat Espuña-Pons
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Francisco Carmona-Herrera
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Cristina Ros-Cerro.

Ethics declarations

Conflict of Interest

Dr. Bataller was a consultant for AMS (Astora Women’s Health). The remaining authors claim no conflicts of interest.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Anglès-Acedo, S., Ros-Cerro, C., Escura-Sancho, S. et al. Female sexuality before and after sacrocolpopexy or vaginal mesh: is vaginal length one of the key factors?. Int Urogynecol J 33, 143–152 (2022). https://doi.org/10.1007/s00192-021-04697-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00192-021-04697-y

Keywords

Search

Navigation