Sexual dysfunction after trocar-guided transvaginal mesh repair of pelvic organ prolapse.
OBJECTIVE
To estimate sexual dysfunction before and after trocar-guided transvaginal mesh surgery for pelvic organ prolapse.


METHODS
Sexually active women participating in a prospective multicenter study were recruited at 26 centers. All participants underwent a standardized surgical procedure and were evaluated before (n=105) and 1 year after (n=84) surgery using the short form of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12). Nonparametric statistics were used for comparisons.


RESULTS
Mean age at surgery was 61.5 years (standard deviation [SD] 7.6), median parity was 2 (range, 1-6), and mean body mass index was 26.8 (SD 4.3) (body mass index is calculated as weight (kg)/[height m]). Anterior transvaginal mesh repair was performed in 46 patients (44%), posterior in 26 patients (25%), and combined anterior and posterior in 33 patients (31%). Overall sexual function scores worsened from 15.5 (SD 8.0) at baseline to 11.7 (SD 6.9) 1 year after surgery (P<.001). The trend toward deteriorating sexual function scores was similar for all three surgical procedures. There was an overall worsening of all symptoms in the behavioral-emotive and partner-related items, whereas improvements were observed in physical function. Overall rates and severity of dyspareunia in specific neither improved nor worsened.


CONCLUSIONS
Sexual function scores deteriorate 1 year after trocar-guided transvaginal mesh surgery. The worsening was attributed primarily to a worsening in behavioral-emotive and partner-related items. Anatomical cure after surgery was not associated with improved PISQ scores.


BACKGROUND
ClinicalTrials.gov, www.clinicaltrials.gov, NCT00402844


METHODS
II.
Altman
Daniel
D
From the Department of Medical Epidemiology and Biostatistics, the Division of Obstetrics and Gynecology, and the Division of Surgery and Urology, Department of Clinical Sciences, Karolinska Institutet, Stockholm, Sweden; the Department of Obstetrics and Gynecology, Turku University Hospital, Turku, Finland; the Department of Obstetrics and Gynecology, Akershus University Hospital, University of Oslo, Lørenskog, Norway; and the Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
Elmér
Caroline
C
Kiilholma
Pentti
P
Kinne
Ingebjørg
I
Tegerstedt
Gunilla
G
Falconer
Christian
C
D000368:Aged; D004414:Dyspareunia / Q000209:etiology; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D006801:Humans; D008875:Middle Aged; D012735:Sexual Dysfunction, Physiological / Q000209:etiology*; D020018:Sexual Dysfunctions, Psychological / Q000209:etiology*; D013525:Surgical Instruments; D013526:Surgical Mesh; D014596:Uterine Prolapse / Q000601:surgery*