Impact Of Pelvic Reconstructive Surgery On Female Sexual Function

Objective:To evaluate sexual function in women who underwent pelvic reconstructive surgery using the Pelvic Organ Prolapse-Urinary Incontinence Sexual Questionnaire -12 (PISQ-12), and to compare the effect on patients'sexual function between pelvic reconstructive surgery with and without synthetic mesh.Method:From August 2002 to November 2010, 71 sexually active women who underwent pelvic reconstructive surgery in our department were studied. 28 women underwent pelvic reconstructive surgery with synthetic mesh, and the other 43 women underwent pelvic reconstructive surgery without synthetic mesh. The median follow-up time was(41.9±24.4)months. Sexual function was evaluated preoperatively and postoperatively using PISQ-12. Single factor analysis of variance and paired t tests were used in data analysis. Significance was set at P<0.05.Results:The total score of PISQ-12 in patients who underwent pelvic reconstructive surgery without synthetic mesh raised from(31.628±4.299)to(33.651±3.199),P<0.05,and 76.74% of the patients'total score improved. 90.69% of the pateints were satisfied with the sexual outcome. The score of the questions'leak urine in sexual activity'(2.860 to 3.488, P<0.001),'fear of incontinence restrict sexual activity'(3.302 to 3.860, P<0.001),'negative emotion reactions in sexual activity'(2.860 to 3.558, P<0.005)all increased. But the score of'sexual pain'decreased from 2.627 to 2.255, P<0.05. The behavioral-emotive and partner-related domain scores did not change much.The total score of PISQ-12 in patients who underwent pelvic reconstructive surgery with synthetic mesh rose from(26.571±4.977)to(32.5±3.283),P<0.05. 89.29% of the patients'total score improved, and 96.43% of the patients were satisfied with the sexual outcome. The physical domain items including'leak urine in sexual activity'(2.178 to 3.678, P<0.001),'fear of incontinence restrict sexual activity'(2.464 to 3.785, P<0.001),'bulging in the vagina restrict sexual activity'(2.428 to 3.607, P<0.05),'negative emotion reactions in sexual activity'(1.821 to 3.5, P<0.05)improved. The behavioral-emotive domain items such as'ability to climax'(1.321 to 1.178, P<0.005)and'frequency of sexual exciting'(1.214 to 0.678, P<0.005)had worse scores. The partner-related domain scores did not change.Conclusion:Most women reported improvements in total sexual function afer pelvic reconstructive surgery, and most patints were satisfied with the sexual outcome, which showed by the increased scores of the physical domain items such as'leak urine in sexual activity','incontinence and bulging restrict sexual activity','negative emotion reactions in sexual activity'. The improving degrees on patients'sexual function between pelvic reconstructive surgery with and without synthetic mesh were similar, but the surgery using synthetic mesh had more significant improvement, which greatly reduced the pelvic floor dysfunction symptoms'effect on sexual life.