title: Medium-term changes in vaginal accommodation and sexual function after vaginal reconstructive surgery.
abstract: OBJECTIVE
  Vaginal shortening and narrowing is an uncommon complication of vaginal reconstructive surgery for prolapse and may cause sexual dysfunction and dyspareunia. We hypothesize that vaginal length, caliber, and sexual function will remain unchanged between the initial (6 weeks to 6 months) and medium-term (18-36 months) postoperative periods.
  
  
  METHODS
  Women who had previously undergone native tissue vaginal reconstructive surgery for symptomatic pelvic organ prolapse and did not undergo intentional vaginal shortening and narrowing were invited to participate by completing a survey and undergoing a physical examination. Vaginal obturators of variable diameters were used to measure vaginal length and caliber. Sexual function was assessed using the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire-12. Women were asked to complete the same checklist assessing barriers (if not sexually active) or interfering factors (if sexually active) to sexual activity.
  
  
  RESULTS
  Survey results were available from 41 women with mean ± SD age at surgery of 63.7 ± 10.6 years. Among those sexually active at both postoperative periods (22 women), mean Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire-12 scores were unchanged between the initial and medium-term postoperative periods (34.1 ± 6.0 vs 32.9 ± 6.0; P = 0.19). Vaginal dryness was the most common interfering factor to sexual activity. Vaginal length and caliber were unchanged between measurements at the initial postoperative and the medium-term postoperative periods.
  
  
  CONCLUSIONS
  There was no significant change in vaginal anatomy measurements or sexual function between initial (6 weeks to 6 months) and medium-term (18-36 months) postoperative periods after vaginal reconstructive surgery.
authors.affiliation: From the Divisions of *Gynecologic Surgery and †Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN.
authors.forename: Shunaha
authors.initials: S
authors.lastname: Kim-Fine
authors.forename: Carin Y
authors.initials: CY
authors.lastname: Smith
authors.forename: John B
authors.initials: JB
authors.lastname: Gebhart
authors.forename: John A
authors.initials: JA
authors.lastname: Occhino
mesh_terms: D000368:Aged; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects*; D006801:Humans; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000009:adverse effects*; D012725:Sexual Behavior; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014621:Vagina / Q000033:anatomy & histology / Q000601:surgery