Top

International Urogynecology Journal

Published in:

Open Access 01-04-2016 | Original Article

Prolapse or incontinence: what affects sexual function the most?

Authors: Swati Jha, Deepa Gopinath

Published in: International Urogynecology Journal | Issue 4/2016

Abstract

Introduction and hypothesis

Pelvic organ prolapse (POP) and stress urinary incontinence (SUI) adversely affect sexual function in women. Comparative studies of the two subgroups are few and results are conflicting. The aim of this study was to compare the effect of POP and SUI on the sexual function of women undergoing surgery for these conditions.

Methods

The study population comprised women with POP or SUI in a tertiary referral hospital in the UK. Women who underwent SUI surgery had no symptoms of POP and had urodynamically proven stress incontinence. Patients with POP had ≥ stage 2 prolapse, without bothersome urinary symptoms. Pre-operative data on sexual function were collected and compared using an electronic pelvic floor assessment questionnaire (ePAQ). The incidence of sexual dysfunction and comparison of symptoms in both groups were calculated using the Mann–Whitney U test.

Results

Three hundred and forty-three women undergoing surgery for either SUI or POP were included. Patients were age-matched, with 184 undergoing SUI surgery (age range 33–77 years) and 159 POP surgery (age range 27–78 years; p = 0.869). The overall impact of POP and SUI was not significantly different in the two subgroups (p = 0.703). However, both patients (73 % vs 36 %; p = 0.00) and partners (50 % vs 24 %; p = 0.00) avoid intercourse significantly more frequently in cases with POP compared with SUI. This did not have a significant impact on quality of life.

Conclusions

The impact of bothersome SUI or POP on sexual function was found to be similar, but patient and partner avoidance in women with POP was greater than those with SUI.

Rohr G, Stovring H, Christensen K, Gaist D, Nybo H, Kragstrup J (2005) Characteristics of middle-aged and elderly women with urinary incontinence. Scand J Prim Health Care 23(4):203–208CrossRefPubMed

Samuelsson EC, Victor FT, Tibblin G, Svardsudd KF (1999) Signs of genital prolapse in a Swedish population of women 20 to 59 years of age and possible related factors. Am J Obstet Gynecol 180(2 Pt 1):299–305CrossRefPubMed

Roos AM, Sultan AH, Thakar R (2012) Sexual problems in the gynecology clinic: are we making a mountain out of a molehill? Int Urogynecol J 23(2):145–152CrossRefPubMed

Pauls RN, Silva WA, Rooney CM et al (2007) Sexual function after vaginal surgery for pelvic organ prolapse and urinary incontinence. Am J Obstet Gynecol 197(6):622–627PubMed

Celik DB, Kizilkaya BN, Yalcin O (2014) Sexual function in women after urinary incontinence and/or pelvic organ prolapse surgery. J Clin Nurs 23(17–18):2637–2648CrossRefPubMed

Lukacz ES, Whitcomb EL, Lawrence JM, Nager CW, Contreras R, Luber KM (2007) Are sexual activity and satisfaction affected by pelvic floor disorders? Analysis of a community-based survey. Am J Obstet Gynecol 197(1):88.e1–88.e6CrossRef

Weber AM, Walters MD, Schover LR, Mitchinson A (1995) Sexual function in women with uterovaginal prolapse and urinary incontinence. Obstet Gynecol 85(4):483–487CrossRefPubMed

Barber MD, Visco AG, Wyman JF, Fantl JA, Bump RC (2002) Sexual function in women with urinary incontinence and pelvic organ prolapse. Obstet Gynecol 99(2):281–289PubMed

Handa VL, Cundiff G, Chang HH, Helzlsouer KJ (2008) Female sexual function and pelvic floor disorders. Obstet Gynecol 111(5):1045–1052CrossRefPubMedPubMedCentral

10.

Handa VL, Harvey L, Cundiff GW, Siddique SA, Kjerulff KH (2004) Sexual function among women with urinary incontinence and pelvic organ prolapse. Am J Obstet Gynecol 191(3):751–756CrossRefPubMed

11.

Radley SC, Jones GL, Tanguy EA, Stevens VG, Nelson C, Mathers NJ (2006) Computer interviewing in urogynaecology: concept, development and psychometric testing of an electronic pelvic floor assessment questionnaire in primary and secondary care. BJOG 113(2):231–238CrossRefPubMed

12.

Roos AM, Thakar R, Sultan AH, Burger CW, Paulus AT (2014) Pelvic floor dysfunction: women’s sexual concerns unraveled. J Sex Med 11(3):743–752CrossRefPubMed

13.

Kammerer-Doak D (2009) Assessment of sexual function in women with pelvic floor dysfunction. Int Urogynecol J Pelvic Floor Dysfunct 20 [Suppl 1]:S45–S50CrossRefPubMed

14.

Rogers RG (2013) Sexual function in women with pelvic floor disorders. Can Urol Assoc J 7(9–10 [Suppl 4]):S199–S201PubMedPubMedCentral

15.

Ozel B, White T, Urwitz-Lane R, Minaglia S (2006) The impact of pelvic organ prolapse on sexual function in women with urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct 17(1):14–17CrossRefPubMed

16.

Ellerkmann RM, Cundiff GW, Melick CF, Nihira MA, Leffler K, Bent AE (2001) Correlation of symptoms with location and severity of pelvic organ prolapse. Am J Obstet Gynecol 185(6):1332–1337CrossRefPubMed

17.

Braekken IH, Majida M, Ellstrom EM, Bo K (2015) Can pelvic floor muscle training improve sexual function in women with pelvic organ prolapse? A randomized controlled trial. J Sex Med 12(2):470–480CrossRefPubMed

18.

Jha S, Gray T (2015) A systematic review and meta-analysis of the impact of native tissue repair for pelvic organ prolapse on sexual function. Int Urogynecol J 26(3):321–327CrossRefPubMed

19.

Dua A, Jha S, Farkas A, Radley S (2012) The effect of prolapse repair on sexual function in women. J Sex Med 9(5):1459–1465CrossRefPubMed

20.

Jha S, Ammenbal M, Metwally M (2012) Impact of incontinence surgery on sexual function: a systematic review and meta-analysis. J Sex Med 9(1):34–43CrossRefPubMed

21.

Jha S, Radley S, Farkas A, Jones G (2009) The impact of TVT on sexual function. Int Urogynecol J Pelvic Floor Dysfunct 20(2):165–169CrossRefPubMed

22.

Ulrich D, Dwyer P, Rosamilia A, Lim Y, Lee J (2015) The effect of vaginal pelvic organ prolapse surgery on sexual function. Neurourol Urodyn 34(4):316–321CrossRefPubMed

23.

Roos AM, Thakar R, Sultan AH, Scheer I (2009) Female sexual dysfunction: are urogynecologists ready for it? Int Urogynecol J Pelvic Floor Dysfunct 20(1):89–101CrossRefPubMed

Title: Prolapse or incontinence: what affects sexual function the most?
Authors: Swati Jha
Deepa Gopinath
Publication date: 01-04-2016
Publisher: Springer London
Published in: International Urogynecology Journal / Issue 4/2016
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-015-2887-2

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Prolapse or incontinence: what affects sexual function the most?

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 4/2016

Highlights of the 40th IUGA meeting in Nice, June 2015

Concomitant apical suspensory procedures in women with anterior vaginal wall prolapse in the United States in 2011

Response to the letter to the editor by Shek et al. on Vergeldt et al: Risk factors for pelvic organ prolapse and its recurrence: a systematic review

Carl Gustav Nilsson 1944–2015

Technique of extraperitoneal uterosacral ligament suspension for apical suspension

Time efficiency of a web-based questionnaire in urogynecology: a randomized study