Changes of the quality of sexual life following pelvic organ prolapse surgery

Abstract

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. Patients who underwent prolapse surgery were included in the study. Before the operation, a complete urogynecological examination was performed, including ultrasound examination, history and POP-Q (pelvic organ prolapse quantification system) 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. 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 the patients even in the advanced stage of pelvic organ setup was reported preoperatively by 45.9% of women and postoperatively – after 1 year – by 44.8% of women. Comparing the quality of life preoperatively and postoperatively, there was a very significant improvement in 58.0% of respondents, a significant improvement in 36.0% and a slight improvement in 2.0%: only in 3.0% of women, there was a deterioration (ranging from mild to very significant). 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. A high percentage of patients are sexually active even at an advanced stage of descent. 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, its quality remains at the same level, but the largest section of the studied group feels a significant improvement in the perception of sexual activities.