Surgical Management for Pelvic Organ Prolapse and Its Impact on Sexual Function.

Abstract

Female sexual function is complex, incorporating physical, emotional, and psychological factors. Pelvic organ prolapse, descent of the pelvic organs to or through the vaginal opening, is a common condition that affects quality of life, including sexual function. Symptomatic prolapse is most commonly treated with reconstructive surgery. To address the surgical management of pelvic organ prolapse and its impact on sexual function and include recommendations for evaluating sexual function, use of validated questionnaires to assess function, preoperative counseling, and postoperative follow-up. A literature search was performed for articles evaluating sexual function after pelvic organ prolapse surgery. Priority was given to larger studies, including systematic reviews, and use of validated questionnaires. The main outcome was postoperative sexual function after pelvic organ prolapse repair. Multiple surgical approaches are used for the treatment of pelvic organ prolapse, including native tissue and grafted repairs. An evaluation of sexual function preoperatively is necessary to decide on type of surgery and to establish appropriate postoperative expectations. Postoperatively, most patients report sexual function as improved or unchanged. Thorough preoperative counseling allows patients and their physicians to develop appropriate, individualized treatment plans for pelvic organ prolapse that consider women's preoperative sexual function and sexual function goals.