Short term impact on female sexual function of pelvic floor reconstruction with the Prolift procedure.
BACKGROUND
The Prolift system is an effective and safe procedure using mesh reinforcement for vaginal reconstruction of pelvic organ prolapse (POP), but its effect on sexual function is unclear.


OBJECTIVE
To evaluate the impact of transvaginal pelvic reconstruction with Prolift on female sexual function at 6 months post-operatively.


METHODS
Thirty-three sexually active women who underwent Prolift mesh pelvic floor reconstruction for symptomatic POP were evaluated before and 6 months after surgery. Their sexual function was assessed by using the short form of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) before and after surgery. The quality of life was also evaluated with the short forms of the Urogenital Distress Inventory (UDI-6) and the Incontinence Impact Questionnaire (IIQ-7) as a control for efficacy of the procedure. The Pelvic Organ Prolapse Quantification system was used to evaluate the degree of prolapse.


METHODS
PISQ-12 scores at 6 months post-operatively.


RESULTS
The total PISQ-12 score decreased from 29.5 +/- 9.0 to 19.3 +/- 14.7 (P < 0.001), indicating worsening of sexual function 6 months post-operatively. The behavioral, physical, and partner-related domains of PISQ-12 were each significantly reduced (5.2 +/- 3.7 vs. 2.9 +/- 3.7, P = 0.016; 15.4 +/- 4.7 vs. 10.4 +/- 8.6, P = 0.001; 8.9 +/- 3.8 vs. 6.4 +/- 5.5, P = 0.01, respectively). UDI-6 and IIQ-7 scores were significantly improved at the 6-month follow-up, as was anatomic recovery. Of the 33 subjects, 24 (73%) had worse sexual function 6 months after the procedure.


CONCLUSIONS
The Prolift procedure provided an effective anatomic cure of POP, but it had an adverse effect on sexual function at 6 months after surgery.
Su
Tsung-Hsien
TH
Mackay Memorial Hospital-Division of Urogynecology, Department of Obstetrics and Gynecology, Taipei, Taiwan 92, Chung-San North Road, Section 2, Taipei 104, Taiwan. drtshu@mail.itrip.com.tw
Lau
Hui-Hsuan
HH
Huang
Wen-Chu
WC
Chen
Shwu-Shiuang
SS
Lin
Tzu-Yin
TY
Hsieh
Ching-Hung
CH
Yeh
Ching-Ying
CY
D005260:Female; D006801:Humans; D008875:Middle Aged; D017773:Pelvic Floor / Q000601:surgery; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D011184:Postoperative Period; D011788:Quality of Life; D012720:Severity of Illness Index; D012725:Sexual Behavior / Q000502:physiology; D012735:Sexual Dysfunction, Physiological / Q000209:etiology / Q000601:surgery; D011795:Surveys and Questionnaires; D013997:Time Factors; D014549:Urinary Incontinence / Q000503:physiopathology / Q000601:surgery