Sexual function and vaginal anatomy in women before and after surgery for pelvic organ prolapse and urinary incontinence

OBJECTIVE: We sought to describe sexual function in women before and after surgery for either prolapse or urinary incontinence, or both. STUDY DESIGN: Women completed questionnaires, and vaginal dimensions were m easured before and at least 6 months after surgery for prolapse or incontin ence. Comparisons were made with signed-rank tests or the McNemar test. RESULTS: Eighty-one (49%) of 165 women were sexually active before and afte r surgery; their mean age was 54.0 +/- 9.9 years. Mean frequency of interco urse did not change. Dyspareunia was reported by 6 (8%) women preoperativel y and 15 (19%) women after surgery; dyspareunia persisted postoperatively i n 1 woman, developed in 14, and resolved in 5 (P = .04). Dyspareunia occurr ed in 14 (26%) of 53 women after posterior colporrhaphy (P = .01) and in 8 (38%) of 21 women who had Burch colposusupension and posterior colporrhaphy performed together (P = .02). Vaginal dimensions decreased slightly after surgery; however, this did not correlate with any change in sexual function . Preoperatively, 66 (82%) women were satisfied with their sexual relations hips, compared with 71 (89%) who were satisfied postoperatively. CONCLUSION: Sexual function and satisfaction improved or did not change in most women after surgery for either prolapse or urinary incontinence, or bo th. However, the combination of Burch colposusupension and posterior colpor rhaphy was especially likely to result in dyspareunia.