Changes of Quality of sexual life following POP surgery

Abstract

Objective: The aim of the study was to determine the percentage of sexually active women with a higher degree of descent in the anterior and middle compartment (in one compartment at least ≥III degree) and how the surgical solution affects the quality of sexual life and overall quality of life in women who underwent surgery.

Study type: Retrospective study.

Setting: Department of Gynecology and Obstetrics, First Medical Faculty, Charles University and General Hospital, Prague.

Methods: Patients who underwent prolapse surgery were included in the study. Before the operation, a complete urogynecological examination was performed, including ultrasound examination, history and POPQ evaluation, and quality of life questionnaires were completed. We compared the quality of sexual life in sexually active women before and after surgery to ascertain the effect of surgery in this respect.

Results: The study included 128 patients who underwent pelvic organ descent surgery from January 2018 to April 2019. Depending on the type of operation, they were divided into three groups: reconstruction with anterior vaginal implant fixed to the sacrospinous ligament, laparoscopic sacrocolpopexy and sacrospinous vaginofixation according to Amreich-Richter. The differences between the groups in the results of the surgical solution were not statistically significant due to the size of the monitored group. Sexual activity of patients even in the advanced stage of pelvic organ setup was preoperatively at 45.9% of women and postoperatively – after 1 year – at 44.8% of women. When comparing the quality of life preoperatively and postoperatively, there was a very large improvement in 58.0% of respondents, a large improvement in 36.0% and a slight improvement in 2.0%: only in 3.0% of women was there in any deterioration (mild to a very large deterioration). Surgical treatment of the descent slightly worsened the quality of sexual life in 20.8% of women, did not change it in 33.3% and significantly improved it in 45.8% of them.

Conclusion: A high percentage of patients are sexually active even at an advanced stage of descent. When comparing the quality of life preoperatively and postoperatively, there was a significant improvement or even complete resolution of the problems associated with descent in most women. For some women, the surgical treatment of the descent may slightly worsen the quality of sexual life, in others the quality of sexual life remains at the same level, but the largest section of the studied group feels a significant improvement in the perception of sexual activities.