Intervention Counseling for Return to Sex After Urogynecologic Surgery: A Randomized Controlled Trial

Area of Science:

• Urogynecology and Reconstructive Pelvic Surgery
• Sexual Health and Postoperative Recovery

Background:

• Pelvic organ prolapse (POP) and urinary incontinence (UI) surgeries can impact patients' sexual health.
• Standard postoperative counseling may not adequately prepare patients for resuming sexual activity.
• ClinicalTrials.gov identifier: NCT05342090.

Purpose of the Study:

• To compare the effectiveness of intervention counseling versus usual counseling on postoperative sexual activity preparedness.
• To assess the impact on dyspareunia and timing of return to sexual activity after POP/UI surgery.

Main Methods:

• Multicenter randomized clinical trial involving patients undergoing POP or UI surgery.
• Patients received either intervention or usual counseling 6-8 weeks postoperatively.
• Preparedness, pain, and sexual function (using PISQ-IR) were assessed up to 6 months postoperatively.

Main Results:

• No significant difference in preparedness was observed at the time of return to sexual activity.
• Intervention counseling led to higher preparedness (OR 2.42) and reduced dyspareunia (OR 0.27) at 6-8 weeks.
• Patients receiving intervention counseling returned to sexual activity earlier (HR 1.46).

Conclusions:

• Intervention counseling improved sexual activity preparedness and decreased dyspareunia at 6-8 weeks post-surgery.
• Preparedness was not significantly different upon actual return to sexual activity.
• A substantial proportion of patients resumed sexual activity before the recommended 6-8 week period.