title: A systematic review and meta-analysis of the impact of native tissue repair for pelvic organ prolapse on sexual function.
abstract: OBJECTIVE
  The aim of this review was to investigate the impact of native tissue repair for pelvic organ prolapse (POP) on overall sexual function and dyspareunia.
  
  
  METHODS
  Cochrane Incontinence Group Specialized Register of Controlled Trials, The Cochrane Central Register of Controlled Trials, MEDLINE, and Embase were searched for trials of prolapse surgery assessing sexual function and dyspareunia before and after surgery. We assessed observational studies and randomized controlled trials investigating the impact of surgical correction of POP on sexual function. Surgical interventions assessed were anterior and/or posterior repair with or without a vaginal hysterectomy. Studies including patients undergoing concurrent incontinence surgery or vaginal mesh insertion were excluded from the analysis. Dyspareunia was analyzed separately.
  
  
  RESULTS
  We identified 674 potential citations, of which 14 articles assessed sexual function and/or dyspareunia before and after traditional prolapse surgery. The results suggest evidence for significant improvement in sexual function postsurgery, with a standardized mean difference of -0.55, 95 % confidence interval (CI) -0.68 to -0.43 in favor of surgical correction. Dyspareunia rates were also significantly improved postoperatively, with overall odds ratio of at least 2.5 times as likely as the chances of deterioration.
  
  
  CONCLUSIONS
  Sexual function is significantly improved and dyspareunia significantly reduced following native tissue prolapse surgery. There were several methodological problems with the quality of the primary research, particularly related to study heterogeneity, use of different outcome measures, and absence of well-designed randomized controlled trials.
authors.affiliation: Department of Urogynaecology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield Teaching Hospitals Level 4 Jessop Wing Tree Root Walk, Sheffield, S10 2SF, UK, swatijha83@hotmail.com.
authors.forename: Swati
authors.initials: S
authors.lastname: Jha
authors.forename: Thomas
authors.initials: T
authors.lastname: Gray
mesh_terms: D004414:Dyspareunia / Q000209:etiology*; D005260:Female; D006801:Humans; D056887:Pelvic Organ Prolapse / Q000150:complications* / Q000601:surgery*; D012735:Sexual Dysfunction, Physiological / Q000209:etiology; D019529:Sexuality