Quality of Sexual Life after Native Tissue versus Polypropylene Mesh Augmented Pelvic Floor Reconstructive Surgery

Area of Science:

• Urology
• Gynecology
• Sexual Medicine

Background:

• Controversies exist regarding reconstructive surgical techniques for pelvic organ prolapse (POP).
• Assessing surgical outcomes requires evaluating patient-reported quality of life, particularly sexual function.

Purpose of the Study:

• To compare the quality of sexual life (QoSL) after vaginal native tissue repair (VNTR) versus transvaginal mesh (TVM) surgery for POP.
• To evaluate the efficacy of these surgical approaches using validated questionnaires.

Main Methods:

• A study involving 121 sexually active women with symptomatic POP undergoing reconstructive surgery (VNTR or TVM) and 50 controls.
• Utilized Pelvic Organ Prolapse/Incontinence Sexual Questionnaire (PISQ-12) and Female Sexual Function Index (FSFI) to assess QoSL.
• Statistical analyses included t-tests, ANOVA, Mann-Whitney U, and Kruskal-Wallis tests.

Main Results:

• Both VNTR and TVM significantly improved sexual quality of life post-surgery (PISQ-12 scores increased from 27.24 to 32.43; p < 0.001).
• No significant differences in QoSL were found between the VNTR and TVM groups based on PISQ-12 (p = 0.19) and FSFI (p = 0.54) results.
• Vaginal native tissue repair (VNTR) emerged as the preferred treatment for uncomplicated primary POP.

Conclusions:

• Reconstructive surgery for POP, including both VNTR and TVM, leads to significant improvements in sexual function.
• VNTR is the recommended surgical approach for uncomplicated primary POP due to comparable sexual quality of life outcomes and potentially fewer complications associated with mesh.
• Further research may explore long-term outcomes and patient satisfaction across different POP severities and surgical techniques.