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Relationship of postoperative vaginal anatomy and sexual function: a systematic review with meta-analysis

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Abstract

Introduction and hypothesis

This was a planned secondary analysis of a systematic review that described sexual function outcomes following pelvic organ prolapse (POP) surgery. We aimed to describe the relationship of pre- and postoperative vaginal anatomic measures with sexual function outcomes. Data Sources included the Medline, Embase, and clinicaltrials.gov databases from inception to April 2018.

Methods

The original systematic review included prospective, comparative studies that reported sexual function outcomes before and following POP surgery. Studies were extracted for population characteristics, sexual function outcomes, and vaginal anatomy, including total vaginal length (TVL) and genital hiatus. By meta-regression, we analyzed associations across studies between vaginal anatomic measurements and sexual function using the Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire-12 (PISQ-12) and dyspareunia outcomes.

Results

We screened 3124 abstracts and identified 74 papers representing 67 original studies. Among these, 14 studies reported TVL and PISQ-12 outcomes. Nine studies reported TVL and dyspareunia outcomes, eight studies reported GH and PISQ-12 outcomes, and seven studies reported GH and dyspareunia outcomes. We found no associations between anatomic measures and PISQ-12 or dyspareunia, although, we found a statistically significant association found between preoperative TVL and change in PISQ-12.

Conclusion

Across studies, the evidence does not support an association between vaginal anatomy and either validated, condition-specific sexual function questionnaires or dyspareunia. However, no study has directly analyzed these associations in the setting of pelvic floor reconstructive surgery.

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Acknowledgements

The authors acknowledge the generous support of the members and Executive Committee of the Society of Gynecologic Surgeons.

This work is supported by the Society of Gynecologic Surgeons (SGS), members of which comprise the Systematic Review Group that performed this review.

Funding

SGS provides no direct funding for this study but supports the organization with provision of meeting space and oversight, stipends for methodology expert and statistical support, and aids in the dissemination of study findings. All work being presented here for publication has been disclosed to and reviewed by the Executive Committee of SGS prior to this submission.

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Cumming School of Medicine, University of Calgary, 4th Floor North Tower, 1403 29th Street NW, Calgary, Alberta, T2N 2T9, Canada

    Shunaha Kim-Fine

  2. Department of Obstetrics and Gynecology, Houston Methodist Hospital, Houston, TX, USA

    Danielle D. Antosh

  3. Center for Evidence Synthesis in Health, Brown University School of Public Health, Providence, RI, USA

    Ethan M. Balk

  4. Department of Obstetrics and Gynecology, University of New Mexico, Albuquerque, NM, USA

    Kate V. Meriwether

  5. Department of Obstetrics and Gynecology, Salinas Valley Memorial Healthcare System, Salinas, CA, USA

    Gregg Kanter

  6. Female Pelvic Medicine and Reconstructive Surgery, MedStar Washington, Hospital Center/Georgetown University School of Medicine, Washington, DC, USA

    Alexis A. Dieter

  7. Department of Obstetrics and Gynecology, Albert Einstein College of Medicine, Bronx, NY, USA

    Mamta M. Mamik

  8. Obstetrics and Gynecology, University of Florida, Jacksonville, FL, USA

    Meadow Good & Ruchira Singh

  9. Department of Obstetrics and Gynecology, UT Health, San Antonio, TX, USA

    Alexandriah Alas

  10. Department of Obstetrics and Gynecology, HCA/UCF Consortium, Gainesville, FL, USA

    Mohamed Foda

  11. Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX, USA

    David D. Rahn

  12. Department of Obstetrics and Gynecology, Albany Medical Center, Albany, NY, USA

    Rebecca G. Rogers

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  1. Shunaha Kim-Fine
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  2. Danielle D. Antosh
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  13. Rebecca G. Rogers
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Corresponding author

Correspondence to Shunaha Kim-Fine.

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Study Registration

This systematic review is registered with PROSPERO (CRD42019124308).

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Kim-Fine, S., Antosh, D.D., Balk, E.M. et al. Relationship of postoperative vaginal anatomy and sexual function: a systematic review with meta-analysis. Int Urogynecol J 32, 2125–2134 (2021). https://doi.org/10.1007/s00192-021-04829-4

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