Factors associated with symptoms of pelvic floor dysfunction six years after primary operation of genital prolapse.

OBJECTIVE: To determine prevalence of pelvic floor dysfunction (PFD) symptoms in women six years after primary pelvic organ prolapse (POP) surgery and analyze predictive factors for these symptoms.

DESIGN: Cross-sectional observational study.

SETTING: Three Swedish hospitals.

SAMPLE: Women who underwent primary POP surgery in 1993 and had no subsequent POP surgery during the following six years.

METHODS: Clinical data from patient records and a postal questionnaire concerning symptoms of PFD completed in 1999.

MAIN OUTCOME MEASURES: Prevalence of PFD symptoms, predictive factors.

RESULTS: Urinary incontinence episodes > or =weekly were reported by 41%, feeling of vaginal bulging by 18% and solid stool incontinence by 15%. Thirty nine percent were sexually active; 15% refrained completely from sexual activity because of own discomfort or pain and 46% had no sexual activity due to lack of or sick partner. Discomfort or pain during sexual activity was experienced by 42%. Previous incontinence surgery and urinary incontinence prior to POP surgery were predictive factors for urinary incontinence. Anterior repair was protective for the postoperative symptoms of incomplete bladder and bowel emptying and vaginal bulging. Posterior repair was a risk factor for incomplete bowel emptying and solid stool incontinence. The association between posterior repair and discomfort or pain during sexual activity was not significant.

CONCLUSION: The prevalence of PFD symptoms six years after primary POP surgery seemed high. The extent of POP surgery was predictive for postoperative symptoms of urinary and bowel dysfunction but not for discomfort or pain during sexual activity.