Retrospective Analysis of Sexual Function After Transvaginal Mesh Surgery.

Area of Science:

• Urogynecology and reconstructive pelvic surgery.
• Sexual medicine and women's health outcomes research.

Background:

• While reconstructive surgery for pelvic organ prolapse (POP) is studied for anatomic and functional results, its impact on sexual function remains debated.
• Dyspareunia is a known concern, but comprehensive sexual outcome data after POP surgery is limited and often equivocal.

Purpose of the Study:

• To evaluate changes in sexual function among women at least 12 months post-transvaginal mesh surgery for POP.
• To identify factors influencing sexual function following POP surgical repair.

Main Methods:

• Retrospective review of 622 women undergoing transvaginal mesh surgery for POP between 2008-2019.
• Sexual function assessed using the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire short form (PISQ-12).
• Analysis included baseline demographics, surgical details, and pre- and post-operative PISQ-12 scores for sexually active women.

Main Results:

• Overall median PISQ-12 scores improved by 2 points (P < .001) in 97 women with complete pre- and post-operative data.
• Significant improvements noted in climax, orgasm intensity, reduced fear/incontinence during intercourse, and decreased avoidance of intercourse due to prolapse.
• Concomitant anal sphincteroplasty negatively impacted sexual function (regression coefficient -4.84), while baseline sexual function positively influenced post-operative scores.

Conclusions:

• Transvaginal mesh surgery demonstrates a positive impact on sexual function in women with POP.
• Improvements in sexual function were independent of the specific mesh product used or the baseline severity of prolapse.
• The findings suggest that mesh surgery can enhance sexual well-being for women experiencing POP.