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ORIGINAL RESEARCH—SURGERY: Short Term Impact on Female Sexual Function of Pelvic Floor Reconstruction with the Prolift Procedure

Authors

  • Tsung-Hsien Su MD, PhD,

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    1. Mackay Memorial Hospital—Division of Urogynecology, Department of Obstetrics and Gynecology, Taipei, Taiwan;
    2. Mackay Medicine, Nursing and Management College, Taipei, Taiwan;
    3. Taipei Medical University—Department of Obstetrics and Gynecology, Taipei, Taiwan;
      Tsung-Hsien Su, MD, PhD, Division of Urogynecology, Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan 92, Chung-San North Road, Section 2, Taipei 104, Taiwan. Tel: +886-2-2543-3535; Fax: +886-2-2754-3769; E-mail: drtshu@mail.itrip.com.tw
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  • Hui-Hsuan Lau MD,

    1. Mackay Memorial Hospital—Division of Urogynecology, Department of Obstetrics and Gynecology, Taipei, Taiwan;
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  • Wen-Chu Huang MD,

    1. Mackay Memorial Hospital—Division of Urogynecology, Department of Obstetrics and Gynecology, Taipei, Taiwan;
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  • Shwu-Shiuang Chen MD,

    1. Mackay Memorial Hospital—Division of Urogynecology, Department of Obstetrics and Gynecology, Taipei, Taiwan;
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  • Tzu-Yin Lin MD,

    1. Taipei City Hospital—Department of Obstetrics and Gynecology, Branch of Women and Children, Taipei, Taiwan;
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  • Ching-Hung Hsieh MD,

    1. Chung-Shan Hospital—Department of Obstetrics and Gynecology, Taipei, Taiwan
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  • Ching-Ying Yeh MD, PhD

    1. Taipei Medical University—Department of Obstetrics and Gynecology, Taipei, Taiwan;
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Tsung-Hsien Su, MD, PhD, Division of Urogynecology, Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan 92, Chung-San North Road, Section 2, Taipei 104, Taiwan. Tel: +886-2-2543-3535; Fax: +886-2-2754-3769; E-mail: drtshu@mail.itrip.com.tw

ABSTRACT

Introduction.  The Prolift system is an effective and safe procedure using mesh reinforcement for vaginal reconstruction of pelvic organ prolapse (POP), but its effect on sexual function is unclear.

Aim.  To evaluate the impact of transvaginal pelvic reconstruction with Prolift on female sexual function at 6 months post-operatively.

Methods.  Thirty-three sexually active women who underwent Prolift mesh pelvic floor reconstruction for symptomatic POP were evaluated before and 6 months after surgery. Their sexual function was assessed by using the short form of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) before and after surgery. The quality of life was also evaluated with the short forms of the Urogenital Distress Inventory (UDI-6) and the Incontinence Impact Questionnaire (IIQ-7) as a control for efficacy of the procedure. The Pelvic Organ Prolapse Quantification system was used to evaluate the degree of prolapse.

Main Outcome Measures.  PISQ-12 scores at 6 months post-operatively.

Results.  The total PISQ-12 score decreased from 29.5 ± 9.0 to 19.3 ± 14.7 (P < 0.001), indicating worsening of sexual function 6 months post-operatively. The behavioral, physical, and partner-related domains of PISQ-12 were each significantly reduced (5.2 ± 3.7 vs. 2.9 ± 3.7, P = 0.016; 15.4 ± 4.7 vs. 10.4 ± 8.6, P = 0.001; 8.9 ± 3.8 vs. 6.4 ± 5.5, P = 0.01, respectively). UDI-6 and IIQ-7 scores were significantly improved at the 6-month follow-up, as was anatomic recovery. Of the 33 subjects, 24 (73%) had worse sexual function 6 months after the procedure.

Conclusion.  The Prolift procedure provided an effective anatomic cure of POP, but it had an adverse effect on sexual function at 6 months after surgery. Su TH, Lau HH, Huang WC, Chen SS, Lin TY, Hsieh CH, and Yeh CY. Short term impact on female sexual function of pelvic floor reconstruction with the Prolift procedure. J Sex Med 2009;6:3201–3207.

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