title: Women's quality of life and sexual function after transvaginal anterior repair with mesh insertion.
abstract: OBJECTIVE
  Current evidence about the impact of pelvic floor surgery on sexual function is conflicting. Only a few studies have reported with validated questionnaires on sexual function after transvaginal mesh repair, with a discrepancy in reported outcomes. The aim of this study was to prospectively explore the impact of anterior repair (AR) with mesh insertion on sexual function, quality of life and dyspareunia.
  
  
  METHODS
  69 women with symptomatic stage II or greater prolapse exclusively of the anterior compartment participated in a prospective study on safety and efficacy of two mesh implantation techniques for anterior vaginal wall prolapse repair between September 2007 and May 2009. They were invited to complete the validated condition-specific short form of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) and quality of life (QoL) questionnaires (Pelvic Organ Prolapse (POP) Distress Inventory (POPDI), Urinary Distress Inventory (UDI), POP Impact Questionnaire (POPIQ), and Urinary Impact Questionnaire (UIQ)) pre-operatively and 6 months post-operatively. All data were processed and analyzed in Statistical Computing Environment R, version 2.9.1.
  
  
  RESULTS
  A significant decrease of Qol scores and a significant increase of PISQ-12 scores occurred after surgery. All sexually active women resumed sexual activity postoperatively. The majority of non-sexually active women remained sexually inactive. Postoperatively the frequency of pain during intercourse increased in 31% of cases and decreased or stayed unchanged in 69% of cases. The incidence of de novo dyspareunia after mesh repair was 4% while the incidence of dyspareunia slightly increased from 25% to 29% postoperatively.
  
  
  CONCLUSIONS
  The results of this study suggest no deterioration in sexual function, a significant improvement in quality of life and a low incidence of de novo dyspareunia six months after AR with mesh insertion. Despite these findings, the majority of non-sexually active women remain sexually inactive postoperatively. These conclusions should be confirmed in a longer follow-up.
authors.affiliation: Department of Obstetrics and Gynecology, 1st Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic. elhaddad@seznam.cz
authors.forename: Rachid
authors.initials: R
authors.lastname: El Haddad
authors.forename: Kamil
authors.initials: K
authors.lastname: Svabik
authors.forename: Jaromir
authors.initials: J
authors.lastname: Masata
authors.forename: Tomas
authors.initials: T
authors.lastname: Koleska
authors.forename: Petr
authors.initials: P
authors.lastname: Hubka
authors.forename: Alois
authors.initials: A
authors.lastname: Martan
mesh_terms: D000368:Aged; D004414:Dyspareunia / Q000209:etiology; D005260:Female; D006801:Humans; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D011184:Postoperative Period; D057234:Preoperative Period; D011446:Prospective Studies; D019919:Prosthesis Implantation / Q000009:adverse effects / Q000379:methods*; D011788:Quality of Life; D012725:Sexual Behavior; D053825:Suburethral Slings / Q000009:adverse effects; D013526:Surgical Mesh / Q000009:adverse effects; D011795:Surveys and Questionnaires