Sexual function after vaginal versus nonvaginal prolapse surgery

To compare sexual function based on the Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire (PISQ) in women who underwent vaginal versus nonvaginal surgery for prolapse.

This was a prospective cohort study of women who underwent vaginal versus nonvaginal (abdominal or robotic) surgery for stage II to stage IV pelvic organ prolapse. We compared 2 groups: those who received vaginal prolapse surgery (defined as any surgical procedure for prolapse requiring incisions in the vaginal wall) and those who received nonvaginal (ie, exclusively abdominal or robotic) prolapse surgery. Women completed the PISQ and additional pelvic floor symptom questionnaires at baseline and 6 months after surgery. Our primary outcome was change in PISQ score from baseline to 6 months.

Of the 80 women in our study population, 58 participants completed 6-month follow-up. Baseline PISQ and pelvic floor symptom questionnaire scores were similar between the vaginal and nonvaginal surgery groups. There were significant overall improvements in sexual function based on the PISQ but no differences in scores between vaginal and nonvaginal surgery groups (mean PISQ change score 6.4±9.2 vs 6.1±14.8; P=0.92). In a linear regression model adjusting for potential confounders, there were still no differences in 6-month PISQ scores between the groups.

In women with prolapse, sexual function is likely to improve after reconstructive surgery, regardless of the route.