title: Changes in sexual function after treatment for prolapse are related to the improvement in body image perception.
abstract: BACKGROUND
  In a previous study, sexual function was related to a woman's self-perceived body image and degree of bother from pelvic organ prolapse (POP).
  
  
  OBJECTIVE
  To evaluate sexual function, prolapse symptoms, and self-perceived body image 6 months following treatment for POP and to explore differences in body image perception and sexual function following conservative and surgical treatment for POP.
  
  
  METHODS
  After institutional review board approval, consecutive women with > or = stage II POP were invited to participate. In addition to routine urogynecologic history and physical examination, including Pelvic Organ Prolapse Quantification (POP-Q), the participants completed three validated questionnaires before, and 6 months after, treatment for POP: Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire, Modified Body Image Perception Scale and Prolapse subscale of Pelvic Floor Distress Inventory to assess condition specific bother from POP. Main Outcome Measures. Changes in sexual function and body image perception following treatment for POP.
  
  
  RESULTS
  A total of 235 women with a mean age of 62 +/- 12 years returned for a 6-month follow-up. The majority of our participants had surgical repair for POP (88%). At 6-month follow-up visits, the patients reported significant improvement in sexual function from baseline (33 +/- 0.6 vs. 43 +/- 0.8, respectively P < 0.0001). Improvement in sexual function, as measured by PISQ-12, was not significant among sexually active patients treated with a pessary compared with those treated surgically (-2.5 +/- 5.5 vs. 11.5 +/- 1, respectively P < 0.0001). A multivariate linear regression model demonstrated that body mass index and changes in body image perception were the only independent factors associated with changes in PISQ score following POP treatment (beta = -0.5, P < 0.01 and beta = -0.4, P < 0.03, respectively).
  
  
  CONCLUSIONS
  Resolution of POP symptoms after treatment improves women's self-perceived body image and sexual function. Not surprisingly, pessary is less effective in improving sexual function compared with surgical repair of POP.
authors.affiliation: Loyola University Medical Center, Chicago, IL, USA. lowensteinMD@gmail.com
authors.forename: Lior
authors.initials: L
authors.lastname: Lowenstein
authors.forename: Tondalaya
authors.initials: T
authors.lastname: Gamble
authors.forename: Tatiana V Deniseiko
authors.initials: TV
authors.lastname: Sanses
authors.forename: Heather
authors.initials: H
authors.lastname: van Raalte
authors.forename: Cassie
authors.initials: C
authors.lastname: Carberry
authors.forename: Sharon
authors.initials: S
authors.lastname: Jakus
authors.forename: Thythy
authors.initials: T
authors.lastname: Pham
authors.forename: Aimee
authors.initials: A
authors.lastname: Nguyen
authors.forename: Kay
authors.initials: K
authors.lastname: Hoskey
authors.forename: Kimberly
authors.initials: K
authors.lastname: Kenton
mesh_terms: D001828:Body Image; D015992:Body Mass Index; D015331:Cohort Studies; D005260:Female; D057227:Femininity; D006305:Health Status Indicators; D006801:Humans; D016014:Linear Models; D008875:Middle Aged; D015999:Multivariate Analysis; D017060:Patient Satisfaction; D056887:Pelvic Organ Prolapse / Q000523:psychology* / Q000601:surgery* / Q000628:therapy; D010570:Pessaries; D011446:Prospective Studies; D011594:Psychometrics; D011788:Quality of Life; D020018:Sexual Dysfunctions, Psychological / Q000209:etiology / Q000523:psychology; D019529:Sexuality; D011795:Surveys and Questionnaires; D016896:Treatment Outcome