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Female Sexual Function and Dysfunction pp 79–87Cite as

POP and Impact of Surgery on Female Sexual Life

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Abstract

Sexual dysfunction is present in almost one third of women with pelvic organ prolapse (POP), causing loss of self-confidence, difficulties in relating to the other sex and abandonment of sexual intercourse.

Only in recent years, the problem of sexuality after POP surgery has been emphasised, and specific questionnaires are available. Among them, the Female Sexual Function Index (FSFI) is a generic questionnaire that has been used in many studies to assess sexual function in women with POP before and after surgery. The ability of a new questionnaire, PISQ-IR, to document condition-specific impact and measure symptoms, including urinary and anal incontinence and POP, suggests this robust tool may be most useful for characterising symptoms in women with POP than generic sexual questionnaires. In addition, the items of the questionnaire were designed to evaluate both sexually active and sexually inactive women and were written to be independent of sexual orientation.

What happens after POP surgery?

Sexual function is significantly improved after vaginal POP surgery. However when a colpoperineorrhaphy is associated with an anterior repair, no improvement in sexual function and higher rates of dyspareunia are reported.

POP surgery with mesh may cause the new onset or worsening of dyspareunia. Instead, sexual activity, desire, arousal, orgasm and satisfaction remain unchanged.

The abdominal sacrocolpopexy, performed via laparotomic, laparoscopic or robotic approaches, gives positive results on sexuality, mainly in desire, arousal and orgasm.

Regarding the uterus-sparing surgery, sacrospinous hysteropexy, the most studied vaginal technique, gives favourable results on sexuality, although the majority of these studies are flawed by selection and information bias, short follow-up or lack of adequate control groups.

Abdominal and laparoscopic hysterosacropexy has the main advantage of ensuring a normal vaginal axis and a good vaginal length, which is mandatory for sexual activity. The main disadvantage is the continuous surveillance required for cervical and uterine malignancies.

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Abbreviations

CSP:

Colposacropexy

FSFI:

Female Sexual Function Index

HSP:

Hysterosacropexy

PISQ:

Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire

PISQ-12:

Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire-short form

PISQ-IR:

Pelvic Organ Prolapse/Incontinence Sexual Questionnaire IUGA-Revised

POP:

Pelvic organ prolapse

QOL:

Quality of life

SSH:

Sacrospinous hysteropexy

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Author information

Authors and Affiliations

  1. Urogynaecology, ICGON, Hospital Clinic, University of Barcelona, Barcelona, Spain

    Montserrat Espuña Pons

  2. Urogynecology Unit, Department of Gynaecology, S. Carlo di Nancy Hospital, Rome, Italy

    Franca Natale

  3. Section of Urology and Andrology, Department of Surgical and Biomedical Sciences, University of Perugia, Perugia, Italy

    Elisabetta Costantini

Authors
  1. Montserrat Espuña Pons
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  2. Franca Natale
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  3. Elisabetta Costantini
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Correspondence to Franca Natale .

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Editors and Affiliations

  1. Department of Urology, University of Perugia, Perugia, Italy

    Elisabetta Costantini

  2. Department of Urology, University of Florence, Florence, Italy

    Donata Villari

  3. SS Annunziata Hospital, Savigliano, Italy

    Maria Teresa Filocamo

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Pons, M.E., Natale, F., Costantini, E. (2017). POP and Impact of Surgery on Female Sexual Life. In: Costantini, E., Villari, D., Filocamo, M. (eds) Female Sexual Function and Dysfunction. Springer, Cham. https://doi.org/10.1007/978-3-319-41716-5_7

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  • DOI: https://doi.org/10.1007/978-3-319-41716-5_7

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