Does post-caesarean dyspareunia reflect sexual malfunction, pelvic floor and perineal dysfunction?

Abstract

The aim was to define post-caesarean dyspareunia as a sexual and pelvic-perineal symptom. Post-caesarean (80 elective, 104 emergency) and 100 vaginally delivered primiparae had domiciliary interviews at 10 months postpartum. A total of 50 (28% and 27%) post-caesarean and 46 (46%) vaginally delivered, reported dyspareunia. Severely impaired general sexual health occurred in 82 (24% elective, 25% emergency, 35% vaginally delivered) as category 3 (dyspareunia with sexual symptoms) and 27 (10% elective, 7% emergency, 12% vaginally delivered) as category 4 (reduced frequency < 6). The risk of dyspareunia (RR 1.14, CI 0.73, 1.77) or impaired general sexual health (RR 0.93, CI 0.32, 2.74) was similar among those with or without perineal trauma. Both caesarean and perineal scars were associated with sexual malfunction. Primiparae with new incontinence had a lower risk of dyspareunia than impaired general sexual health. Awareness of the associations of post-caesarean dyspareunia and impaired general sexual health with incontinence would facilitate appropriate obstetric decision-making. Further research is indicated.

Keywords::

• Dyspareunia
• incontinence
• caesarean
• peritoneal
• postpartum
• sexual ill-health

Acknowledgements

Our special thanks to all participants who took part in this study. Department work is attributed to: Women and Children's Directorate, Dudley Group of Hospitals NHS Foundation Trust, West Midlands DY1 2HQ.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.