2142 SEXUAL CHANGES AFTER POP REPAIR. IS HYSTERECTOMY A KEY ELEMENT ?

Abstract

You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Pelvic Prolapse1 Apr 20122142 SEXUAL CHANGES AFTER POP REPAIR. IS HYSTERECTOMY A KEY ELEMENT ? Elisabetta Costantini, Massimo Lazzeri, Luigi Mearini, Emanuela Frumenzio, Vittorio Bini, and Alessandro Zucchi Elisabetta CostantiniElisabetta Costantini Perugia, Italy More articles by this author , Massimo LazzeriMassimo Lazzeri Perugia, Italy More articles by this author , Luigi MeariniLuigi Mearini Perugia, Italy More articles by this author , Emanuela FrumenzioEmanuela Frumenzio Perugia, Italy More articles by this author , Vittorio BiniVittorio Bini Perugia, Italy More articles by this author , and Alessandro ZucchiAlessandro Zucchi Perugia, Italy More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.2313AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Incontinence and pelvic organ prolapse (POP) impact upon sexuality but reported data are controversial. In this study we want to evaluate changes in sexual activity after POP repair and the impact of uterus preservation. METHODS This is a prospective longitudinal study including 107 patients with severe prolapse, mean age 58 years (r.27-76), who underwent an integral pelvic floor reconstruction with or without hysterectomy (61 hysterectomy and colposacropexy (HY+CSP) and 46 uterus-sparing surgery (HSP)) between January 2006 and Feb 2011:. Inclusion criteria: patients who consent to respond to the FSFI questionnaire, before and after surgery. Pre-operative evaluation included: detailed case history, complete urogynaecological examination, urodynamic assessment, UDI-6 and IIQ-7 questionnaires. At 1 year follow-up patients repeated the FSFI questionnaire and underwent a clinical check-up. Primary outcome is the change of sexual activity after surgery and secondary outcome was to compare 1 year-post-operative sexual activity in patients who underwent hysterectomy or uterus sparing surgery. The Mann-Whitney test and Wilcoxon test for unpaired and paired data respectively, were used to compare questionnaire scores. The level of statistical significance was set at p < 0.05. Data analysis was carried out with Predictive Analytic Software (PASW) release 17.0.2, SPSS Inc., Chicago, USA, 2009. RESULTS 27/107 pts. who were not active before and after surgery (7 HSP; 20 HY+CSP) and 12 pts. who incompletely filled the questionnaire were excluded from the evaluation. Finally 32 pts in the HSP group, mean age 53 years (r. 27-72) and 36 pts. in the HY+CSP group , mean age 58 (r. 40-71) were evaluated. The median pre-operative FSFI scores were comparable in the two groups (p=ns). 21 pts. who were sexually inactive before surgery became active (13 HY+CSP and 8 HSP) and only 2 pts. (1 for each group) worsened and became not active after surgery. Overall FSFI scores showed a statistical improvement after surgery (p<0.05). Furthermore the median post-operative scores of each domains showed a significant improvement in uterus-sparing group comparing with the hysterectomy group: desire (median 3.9 (range 1.2-6) vs. 3 (range 1.2-6); p<0.05), arousal (median 4 (range 0-6) vs. 3.6 (range 0-5.7); p<0.05) and orgasm (median 4.4 (range 0-6) vs. 4 range (1.2-5-2); p<0.05). CONCLUSIONS Our data demonstrated POP repair improves sexual activity. Although the role of hysterectomy on sexual well-being is still not clearly defined, our results showed uterus sparing surgery was associated with improved sexual activity. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e865 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Elisabetta Costantini Perugia, Italy More articles by this author Massimo Lazzeri Perugia, Italy More articles by this author Luigi Mearini Perugia, Italy More articles by this author Emanuela Frumenzio Perugia, Italy More articles by this author Vittorio Bini Perugia, Italy More articles by this author Alessandro Zucchi Perugia, Italy More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...