title: Sexual activity and vaginal topography in women with symptomatic pelvic floor disorders.
abstract: BACKGROUND
  Pelvic floor disorders affect vaginal anatomy and may affect sexual function.
  
  
  OBJECTIVE
  The aims of this study were to explore the relationship between vaginal anatomy and sexual activity in women with symptomatic pelvic floor disorders and to assess whether vaginal measurements (topography) correlate with sexual function.
  
  
  METHODS
  This is a retrospective cohort study comparing sexually active and nonsexually active women planning urogynecologic surgery. Our primary outcome was the difference in vaginal topography based on Pelvic Organ Prolapse Quantification (POP-Q) exam between cohorts. Correlations between POP-Q measurements and Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire short form (PISQ-12) scores were assessed in sexually active women.
  
  
  METHODS
  The POP-Q is a quantitative and standardized examination for prolapse. The PISQ-12 is a condition-specific sexual function questionnaire validated in sexually active women with pelvic floor disorders.
  
  
  RESULTS
  Of 535 women, 208 (39%) were sexually active and 327 (61%) were not. Median genital hiatus (GH) and perineal body (PB) measurements and a PB:GH ratio were not significantly different between the two cohorts. Total vaginal length (TVL) was longer in sexually active women (median 9 vs. 8 cm, P<0.001). In a linear regression analysis controlling for potential confounders, sexually active women still had a longer TVL by 0.4 cm (95% confidence interval 0.07, 0.6 cm) compared with those who were not sexually active. Of the 327 nonsexually active women, 28% indicated they avoided sexual activity because of pelvic floor symptoms. There was poor correlation between TVL, GH, PB, and PB : GH ratio with PISQ-12 scores (r=0.10, -0.05, -0.09, -0.03, respectively).
  
  
  CONCLUSIONS
  In women with pelvic floor disorders, sexual activity is associated with a longer vaginal length. One-quarter of women indicated they avoided sexual activity because of pelvic floor symptoms. Vaginal topography does not correlate with sexual function based on PISQ-12 scores.
authors.affiliation: Department of Obstetrics and Gynecology, Duke University, Durham, NC, USA.
authors.forename: Autumn L
authors.initials: AL
authors.lastname: Edenfield
authors.forename: Pamela J
authors.initials: PJ
authors.lastname: Levin
authors.forename: Alexis A
authors.initials: AA
authors.lastname: Dieter
authors.forename: Cindy L
authors.initials: CL
authors.lastname: Amundsen
authors.forename: Nazema Y
authors.initials: NY
authors.lastname: Siddiqui
mesh_terms: D015331:Cohort Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D017773:Pelvic Floor / Q000033:anatomy & histology / Q000473:pathology*; D056887:Pelvic Organ Prolapse / Q000150:complications / Q000503:physiopathology* / Q000523:psychology; D012189:Retrospective Studies; D012725:Sexual Behavior / Q000523:psychology; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D014549:Urinary Incontinence / Q000150:complications / Q000503:physiopathology* / Q000523:psychology; D014621:Vagina / Q000033:anatomy & histology / Q000473:pathology*
keywords: Pelvic Floor Disorders; Pelvic Organ Prolapse; Sexual Activity; Sexual Dysfunction; Sexual Function; Vaginal Topography