title: Quality of life and sexual changes after double transobturator tension-free approach to treat severe cystocele.
abstract: OBJECTIVE
  To study the quality of life and sexual function changes of women affected by severe cystocele and treated with the double transobturator tension-free approach.
  
  
  METHODS
  23 women (mean age 60.6) with third and fourth degree cystocele (according to Baden and Walker classification) were monitored by Short Form-36 (SF-36) and Pelvic Organ Prolapse/Urinary Incontinenece Sexual Questionnaire (PISQ-12) before and 12 months after surgical treatment. Each woman also underwent translabial color Doppler ultrasonography to measure the Resistance Index (RI), Pulsatility Index (PI), Peak Systolic Velocity (PSV), and End-Diastolic Velocity (EDV) of the clitoral arteries, before surgery and 12 months postoperatively.
  
  
  RESULTS
  SF-36 showed a considerable increase in all of the categories (physical functioning, physical role functioning, bodily pain, general health, vitality, social functioning, emotional role functioning, and mental health) compared to those obtained at baseline (P<0.05). PISQ-12 also showed a considerable increase in the behavioural emotive factor score, in the physical factor score, in the partner-related factor score and, consequently, in the total score compared to that obtained at baseline (P<0.05). Color Doppler measurement showed that the mean Pulsatility Index, Peak Systolic Velocity, Resistance Index and End-Diastolic Velocity were not significantly lower to those obtained at baseline (P=NS).
  
  
  CONCLUSIONS
  Double transobturator tension-free approach to treat severe cystocele considerably improves quality of life and sexual function, and does not significantly influence clitoral blood flow. Our data could add new information about sexual behaviour after prolapse treatment, particularly about the impact on clitoral blood flow changes.
authors.affiliation: Department of Microbiological and Gynecological Sciences, University of Catania, Italy. scaruso@unict.it
authors.forename: Salvatore
authors.initials: S
authors.lastname: Caruso
authors.forename: Sebastiano
authors.initials: S
authors.lastname: Bandiera
authors.forename: Antonino
authors.initials: A
authors.lastname: Cavallaro
authors.forename: Stefano
authors.initials: S
authors.lastname: Cianci
authors.forename: Salvatore Giovanni
authors.initials: SG
authors.lastname: Vitale
authors.forename: Salvatore
authors.initials: S
authors.lastname: Rugolo
mesh_terms: D000328:Adult; D000368:Aged; D002987:Clitoris / Q000098:blood supply / Q000000981:diagnostic imaging; D052858:Cystocele / Q000601:surgery*; D005260:Female; D006801:Humans; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000523:psychology / Q000601:surgery; D011788:Quality of Life; D012725:Sexual Behavior / Q000502:physiology; D018615:Ultrasonography, Doppler, Color; D014550:Urinary Incontinence, Stress / Q000000981:diagnostic imaging / Q000523:psychology / Q000601:surgery*