title: The impact of pelvic floor surgery on female sexual function: a mixed quantitative and qualitative study.
abstract: OBJECTIVE
  To assess whether the current condition-specific sexual function questionnaire provides full insight into sexual function following pelvic floor surgery.
  
  
  METHODS
  Prospective, mixed quantitative and qualitative study.
  
  
  METHODS
  Urogynaecology clinic in a large university hospital.
  
  
  METHODS
  Thirty-seven women undergoing surgery for pelvic organ prolapse (POP) and/or stress urinary incontinence (SUI).
  
  
  METHODS
  Women were seen before surgery and 3 months postoperatively. At both visits the Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire (PISQ) was completed and a qualitative face-to-face semi-structured interview was conducted. PISQ total and domain scores, as well as the change in the preoperative and postoperative score, were calculated and analysed using Wilcoxon signed rank test and one-sample t-test. The qualitative data were systematically analysed using data-matrices.
  
  
  METHODS
  The impact of pelvic floor surgery on female sexual function.
  
  
  RESULTS
  Significant improvement was seen for PISQ total score (P = 0.003) as well as Physical (P < 0.001) and Partner-related (P = 0.002) domains, but not for the Behavioural/Emotive domain (P = 0.220). Analysis of qualitative data showed that improvement in sexual function was a result of cure of POP and SUI symptoms. Deterioration of sexual function was due to dyspareunia, fear of causing damage to the surgical result, new symptoms and a disappointing result of surgery.
  
  
  CONCLUSIONS
  Our qualitative data show that PISQ is limited in the assessment of sexual function after pelvic floor surgery as it does not assess most surgery-specific negative effects on sexual function.
authors.affiliation: Department of Obstetrics and Gynaecology, Croydon University Hospital, Croydon, UK.
authors.forename: A M
authors.initials: AM
authors.lastname: Roos
authors.forename: R
authors.initials: R
authors.lastname: Thakar
authors.forename: A H
authors.initials: AH
authors.lastname: Sultan
authors.forename: J W
authors.initials: JW
authors.lastname: de Leeuw
authors.forename: A T G
authors.initials: AT
authors.lastname: Paulus
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008875:Middle Aged; D017773:Pelvic Floor / Q000601:surgery; D056887:Pelvic Organ Prolapse / Q000150:complications / Q000601:surgery*; D011446:Prospective Studies; D036301:Qualitative Research; D012725:Sexual Behavior; D012735:Sexual Dysfunction, Physiological / Q000209:etiology / Q000601:surgery; D020018:Sexual Dysfunctions, Psychological / Q000209:etiology; D019529:Sexuality; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000150:complications / Q000601:surgery*
keywords: Female sexual function; Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire (PISQ); pelvic floor surgery; qualitative research