Sexual Function after Sacrocolpopexy

Abstract

Pelvic organ prolapse affects approximately 50% of parous women over 50 years of age and has a lifetime risk of 30-50%. Vault descent or prolapse occurs in about 20% after hysterectomy and can have a negative effect on sexual function. Sacrocolpopexy is the gold standard of surgical treatment for apical prolapse in fit, sexually active patients. Few data exist which determine sexual function after sacrocolpopexy. The aim of this study was to determine sexual function in sexually active patients before and after sacrocolpopexy for the treatment of vault prolapse or descent. Main outcome measures were the International Continence Society (ICS) Pelvic Organ Prolapse (ICS POP) Staging and the Female Sexual Function Index, which were filled in before the intervention and at follow-up. Between December 2000 and December 2009, we asked sexually active female patients who were to undergo sacrocolpopexy for vault descent or prolapse to participate in this study. The patients were gynecologically examined before and after surgery and prolapse staging was performed using the ICS POP Staging. Sixty-two patients were included in the study and follow-up was 24 months. The domains sexual desire, arousal, lubrication, satisfaction, and pain improved significantly postoperatively but orgasm remained unchanged. There was no vaginal shortening postoperatively, and no serious intra- or postoperative complications occurred. Sacrocolpopexy is a valuable option for sexually active patients with vault descent or prolapse with an amelioration of most aspects of sexual function but not all. Other factors as hormonal treatment, concomitant surgery, physiological, and psychological factors have to be taken into consideration.