Impact of total vaginal mesh surgery for pelvic organ prolapse on female sexual function.

OBJECTIVE: To evaluate the short-term impact of surgical repair with total transvaginal mesh (TVM) on sexual function among women with pelvic organ prolapse (POP).

METHODS: Twenty-seven sexually active women who underwent total TVM procedures for symptomatic POP at Buddhist Dalin Tzu Chi General Hospital between 2007 and 2010 were included in the retrospective study. Preoperative and postoperative assessments included pelvic examination using the POP quantification (POP-Q) system, urodynamic studies, and a personal interview to evaluate urinary and sexual symptoms via the urogenital distress inventory (UDI-6), incontinence impact questionnaire (IIQ-7), and female sexual function index (FSFI).

RESULTS: The mean patient age was 51.4 years (range 36-68 years) and the mean parity was 2.7(range 0-4). Regarding POP-Q parameters, there were significant improvements at points Aa, Ba, C, Ap, and Bp after surgery (P<0.001). Similarly, the UDI-6 and IIQ-7 scores significantly dropped postoperatively (P<0.01). After surgery, the scores for the dyspareunia and the lubrication domains of FSFI worsened significantly (P<0.05). There was no significant change in other domains (desire, arousal, orgasm, satisfaction, and total score; P>0.05). Two-thirds (66.7%) of women had a lower total FSFI score postoperatively.

CONCLUSION: TVM surgery was found to contribute successfully to the anatomic correction of POP, but individual domains of sexual function sometimes worsened.