Abstract
ABSTRACTPurpose:We aimed to determine pre-operative and post-operative sexual function scores of patients who underwent four-arm polypropylene mesh implantation surgery to treat urinary incontinence and pelvic organ prolapse.Materials and Methods:A prospective study from January 2011 to November 2015 including patients (n: 72) submitted to surgical mesh implantation (four-arm anterior mesh implant (Betamix POP4®, Betatech Medical, Turkey) questioned the patients with Female Sexual Function Index evaluation form. The questionnaire was applied to all patients at pre-operative, post-operative 3rd month and post-operative 1st year periods.Results:The mean age of the patients was 47.2±7.1 years. The mean Body Mass Index (kg/m2) was 28.7±3.7. The average of incontinence duration (year) was 4.6±2.6 and the average for operation time (min) was 35.7±2.1. After the urinary incontinence and pelvic organ prolapse surgery, it was observed that incontinence complaints of patients reduced. Furthermore, there was a positive change in quality of life and sexual function of patients at the post-operative period. There was a statistically significant increase according to Female Sexual Function Index score among all three periods (16%, 86% and 100% respectively, p=0.001) and improvement of sexual functions was observed.Conclusions:Transvaginal mesh use in the surgical treatment of pelvic organ prolapse improves quality of life. However, risk factors such as transvaginal mesh usage indication, surgical technique and experience of the surgeon, suitability of the material, the current health status of the patient and postoperative personal care of the patient may affect the success of operations.
Highlights
Sexuality is a complex process associated with neurological, vascular and endocrine systems [1]
Pelvic organ prolapse refers to the outflow or sagging of the bladder, uterus, vagina, small intestine, or rectum of the pelvic floor organs, down the vaginal canal or anus as a result of prolapse
SUI is the most frequent type of UI only among middle-aged women which is observed at high intraabdominal pressure conditions such as effort, exertion or sneezing or coughing and defined by International Continence Society (ICS) as urinary incontinence, observed when intravesical pressure exceeds urethra pressure with no increase in detrusor muscle activity [6]
Summary
Sexuality is a complex process associated with neurological, vascular and endocrine systems [1]. Usually in postmenopausal or climacteric period, may be observed sometimes in young women who wish to maintain fertility [1,2,3,4] Pelvic floor disorders such as urinary incontinence/pelvic organ prolapse are seen commonly among women at all ages and are not just a long-lasting medical problem and has negative physiologic, psychological, hygienic, economic and sexual effects which all can be summed up under the term “quality of life” [5]. With increasing industrial pressure in the 2000s, there has been increasing mesh complications in mesh surgery with the contribution of patient incompatible mesh material such as monophilized micropore and insufficient surgical experience In this context, the warnings of the FDA limiting the use of mesh were unavoidable. In our country (Turkey) there are very few studies evaluating the UI and/or POP surgerie’s effects on quality of life and sexual functions, which remained under-researched
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