Evaluating sexual function among women after recurrent pelvic organ prolapse transvaginal mesh repair

Abstract

We aimed to evaluate women’s sexual function before and after pelvic organ prolapse (POP) surgery utilising light transvaginal mesh after a prior hysterectomy. Only sexually active women with recurrent cystocele stage 3–4 according to POP-Q, who had previously undergone vaginal hysterectomy with anterior native tissue repair without apical fixation, were enrolled in the study. Women with previous mesh implant POP surgery, persistent vaginal infection or pelvic inflammatory disease were excluded. All patients were surgically treated between 2012 and 2015 using single-incision transvaginal mesh Calistar A. Sexual function was evaluated before a surgery and two years postoperatively. The assessment was accomplished via the standardised validated Czech translation of PISQ-12SF questionnaire. For each patient, age, BMI and parity were monitored. Out of all (89) eligible patients, 48 patients met inclusion criteria and were subsequently enrolled in our study. Two years postoperatively, 31 women (79.5%) improved their PISQ-12 score; five (12.8%) had equivalent scores, and three patients (7.7%) reported lower scores. Overall PISQ-12 score was 37.1 ± 2.6 postoperatively with a 2.9 ± 2.3 statistically significant positive difference compared to the score preceding surgery. The majority of patients undergoing surgery using Calistar A experienced a significant improvement in sexual function.

IMPACT STATEMENT

• What is already known on this subject? Pelvic organ prolapse has a significant impact on women’s sexual functioning in an adverse manner. Mesh implant repair is associated with lower rates of prolapse awareness and prolapse re-operation; however, it is linked with safety concerns. One of these concerns is the negative impact on women’s sexual function. Evaluative study results following sexual function among women with mesh implant transvaginal repair are contradictory.

• What do the results of this study add? The results showed, that contrary to finding some of the previous studies, transvaginal mesh implant use could benefit patients with previous native tissue POP surgery failure with a low risk of sexual function deterioration.

• What are the implications of these findings for clinical practice and/or further research? The study provides clinical data for vaginal mesh implants on women’s sexual function in the mid-term outcome. These data can be crucial for selecting the right POP surgical technique and evaluating its benefits and risks.

Keywords:

• Pelvic organ prolapse
• sexual function
• transvaginal mesh implant

Author contributions

M. Huser designed the study and drafted the manuscript. M. Huser with M. Szypulova as his assistant performed all surgical interventions. M. Huser, M. Dostalova and I. Horvath processed, collected and analysed acquired clinical data. S. Tvarozek wrote the final manuscript and provided clinical data quality control.

Disclosure statement

The authors declare that they have no known competing financial interests or personal relationships that could influence the work reported in this paper.

Additional information

Funding

This work is financially supported by the Czech Republic Ministry of Health – Project FNBr65269705.