title: Sexual Function and Pessary Management among Women Using a Pessary for Pelvic Floor Disorders.
abstract: BACKGROUND
  Pessaries are commonly used to treat pelvic floor disorders, but little is known about the sexual function of pessary users.
  
  
  OBJECTIVE
  We aimed to describe sexual function among pessary users and pessary management with regard to sexual activity.
  
  
  METHODS
  This is a secondary analysis of a randomized trial of new pessary users, where study patients completed validated questionnaires on sexual function and body image at pessary fitting and 3 months later.
  
  
  METHODS
  Women completed the Pelvic Organ Prolapse-Urinary Incontinence Sexual Function Questionnaire, International Urogynecological Association Revised (PISQ-IR), a validated measure that evaluates the impact of pelvic floor disorders on sexual function, a modified female body image scale (mBIS), and questions regarding pessary management surrounding sexual activity.
  
  
  RESULTS
  Of 127 women, 54% (68/127) were sexually active at baseline and 42% (64/114) were sexually active at 3 months. Sexual function scores were not different between baseline and 3 months on all domains except for a drop of 0.15 points (P = 0.04) for sexually active women, and a drop of 0.34 points for non-sexually active women (P = 0.02) in the score related to the sexual partner. Total mBIS score did not change (P = 0.07), but scores improved by 0.2 points (P = 0.03) in the question related to self-consciousness. Pessary satisfaction was associated with improved sexual function scores in multiple domains and improved mBIS scores. The majority (45/64, 70%) of sexually active women removed their pessary for sex, with over half stating their partner preferred removal for sex (24/45, 53%).
  
  
  CONCLUSIONS
  Many women remove their pessary during sex for partner considerations, and increased partner concerns are the only change seen in sexual function in the first 3 months of pessary use. Pessary use may improve self-consciousness and pessary satisfaction is associated with improvements in sexual function and body image.
authors.affiliation: Department of Obstetrics and Gynecology, University of New Mexico, Albuquerque, NM, USA.
authors.forename: Kate V
authors.initials: KV
authors.lastname: Meriwether
authors.affiliation: Department of Obstetrics and Gynecology, University of New Mexico, Albuquerque, NM, USA.
authors.forename: Yuko M
authors.initials: YM
authors.lastname: Komesu
authors.affiliation: Department of Obstetrics and Gynecology, University of New Mexico, Albuquerque, NM, USA.
authors.forename: Ellen
authors.initials: E
authors.lastname: Craig
authors.affiliation: Department of Biostatistics, Clinical Sciences and Translational Center, University of New Mexico, Albuquerque, NM, USA.
authors.forename: Clifford
authors.initials: C
authors.lastname: Qualls
authors.affiliation: Department of Biostatistics, Clinical Sciences and Translational Center, University of New Mexico, Albuquerque, NM, USA.
authors.forename: Herbert
authors.initials: H
authors.lastname: Davis
authors.affiliation: Department of Obstetrics and Gynecology, University of New Mexico, Albuquerque, NM, USA.
authors.forename: Rebecca G
authors.initials: RG
authors.lastname: Rogers
mesh_terms: D001828:Body Image / Q000523:psychology*; D015992:Body Mass Index; D005260:Female; D006801:Humans; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D017060:Patient Satisfaction; D059952:Pelvic Floor Disorders / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D010549:Personal Satisfaction; D010570:Pessaries / Q000706:statistics & numerical data*; D012725:Sexual Behavior / Q000523:psychology; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000503:physiopathology / Q000523:psychology* / Q000628:therapy*
keywords: Body Image; Hygiene; Partner; Pessaries; Remove; Sexual Activity; Sexual Function