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Review article| Volume 92, P56-60, October 2016

Assessment of the impact of urogenital prolapse on sexual dysfunction

      Highlights

      • It is generally the symptoms associated with prolapse (e.g. bladder, bowel and sexual dysfunction) that motivate women to seek medical help.
      • Women with urinary incontinence/pelvic organ prolapse are more likely to restrict sexual activity for fear of incontinence.
      • Because sexual function is so complex, the physical changes consequent to surgery might not address the issues contributing to sexual dysfunction preoperatively.

      Abstract

      Sexual dysfunction is one of the symptoms that motivates women to seek medical help in the management of urogenital prolapse. Conservative or surgical interventions may be offered to treat the prolapse but the question remains as to whether treatment restores sexual function (SF). This article briefly discusses the assessment of SF in women with a urogenital prolapse and reviews the effect of therapeutic interventions on SF.

      Keywords

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      References

        • Maher C.
        • Baessler K.
        • Barber et al M.
        Surgical management of pelvic organ prolapse.
        in: Abrams C. Khoury W. 5th International Consultation on Incontinence. Health Publication Ltd., Paris2013
        • Olsen A.L.
        • Smith V.J.
        • Bergstrom J.O.
        • Colling J.C.
        • Clark A.L.
        Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence.
        Obstet. Gynecol. 1997; 89: 501-506
        • World Health Organisation
        Defining Sexual Health Report of a Technical Consultation on Sexual Health.
        WHO, Geneva2006
        • Pauls R.N.
        • Segal J.L.
        • Silva W.A.
        • Kleeman S.D.
        • Karram M.M.
        Sexual function in patients presenting to a urogynecology practice.
        Int. Urogynecol. J. Pelvic Floor Dysfunct. 2006; 17: 576-580
        • Barber M.D.
        • Visco A.G.
        • Wyman J.F.
        • Fantl J.A.
        • Bump R.C.
        • Continence Program for Women Research Group
        Sexual function in women with urinary incontinence and pelvic organ prolapse.
        Obstet. Gynecol. 2002; 99: 281-289
        • Haylen B.T.
        • Maher C.F.
        • Barber M.D.
        • Camargo S.
        • Dandolu V.
        • Digesu A.
        • Goldman H.B.
        • Huser M.
        • Milani A.L.
        • Moran P.A.
        • Schaer G.N.
        An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic organ prolapse (POP).
        Neurourol. Urodyn. 2016; 35: 137-168
        • World Health Organisation (ICD-10)
        International Statistical Classification of Diseases and Related Health Problems.
        WHO, Geneva1992
        • Basson R.
        • Berman J.
        • Burnett A.
        • Derogatis L.
        • Ferguson D.
        • Fourcroy J.
        • Goldstein I.
        • Garziottin A.
        • Heiman J.
        • et al.
        Report of the International Consensus development conference on female sexual dysfunction.
        J. Urol. 2000; 163: 888-893
        • Mouritsen L.
        Pathophysiology of sexual dysfunction as related to pelvic floor disorders.
        Int. Urogyneacol. J. 2009; 20: S19-S25
        • Gladu R.
        Female sexual dysfunction: classification, physiology, diagnosis and treatment.
        J. Sex. Reprod. Med. 2002; 2: 21-27
        • Bai S.W.
        • Jeon M.J.
        • Kim J.Y.
        • Chung K.A.
        • Kim S.K.
        • Park K.H.
        Relationship between stress urinary incontinence and pelvic organ prolapse.
        Int. Urogynecol. J. Pelvic Floor Dysfunct. 2002; 13 (discussion 60): 256-260
        • Wilkins M.F.
        • Wu J.M.
        Epidemiology of pelvic organ prolapse.
        Curr. Obstet. Gynecol. Rep. 2016; : 1-5
        • Rogers G.R.
        • Villarreal A.
        • Kammerer-Doak D.
        • Qualls C.
        Sexual function in women with and without urinary incontinence and/or pelvic organ prolapse.
        Int. Urogynecol. J. Pelvic Floor Dysfunct. 2001; 12: 361-365
        • Özel B.
        • White T.
        • Urwitz-Lane R.
        • Minaglia S.
        The impact of pelvic organ prolapse on sexual function in women with urinary incontinence.
        Int. Urogynecol. J. 2006; 17: 14-17
        • Hagen S.
        • Stark D.
        • Cattermole D.
        A United Kingdom-wide survey of physiotherapy practice in the treatment of pelvic organ prolapse.
        Physiotherapy. 2004; 90: 19-26
        • Braekken I.H.
        • Majida M.
        • Ellström Engh M.
        • Bø K.
        Can pelvic floor muscle training improve sexual function in women with pelvic organ prolapse? A randomized controlled trial.
        J. Sex. Med. 2015; 12 (Epub 2014 Nov 17): 470-480https://doi.org/10.1111/jsm.12746
        • Hagen S.
        • Stark D.
        • Glazener C.
        • Dickson S.
        • Barry S.
        • Elders A.
        • Frawley H.
        • Galea M.P.
        • Logan J.
        • McDonald A.
        • McPherson G.
        • Moore K.H.
        • Norrie J.
        • Walker A.
        • Wilson D.
        • POPPY Trial Collaborators
        Individualised pelvic floor muscle training in women with pelvic organ prolapse (POPPY): a multicentre randomised controlled trial.
        Lancet. 2014; 1 (Epub 2013 Nov 28. Erratum in: Lancet. 2014 Jul 5;384(9937):28): 796-806https://doi.org/10.1016/S0140-6736(13)61977-7
        • Lowenstein L.
        • Gruenwald I.
        • Gartman I.
        • Vardi Y.
        Can stronger pelvic muscle floor improve sexual function?.
        Int. Urogynecol. J. Pelvic Floor Dysfunct. 2010; 21: 553-556
        • Lowenstein L.
        • Gruenwald I.
        • Gartman I.
        • Vardi Y.
        Can stronger pelvic muscle floor improve sexual function?.
        Int. Urogynecol. J. Pelvic Floor Dysfunct. 2010; 21: 553-556
        • Kuhn A.
        • Bapst D.
        • Stadlmayr W.
        • Vits K.
        • Mueller M.D.
        Sexual and organ function in patients with symptomatic prolapse: are pessaries helpful?.
        Fertil. Steril. 2009; 91: 1914-1918
        • Fernando R.J.
        • Thakar R.
        • Sultan A.H.
        • Shah S.M.
        • Jones P.W.
        Effect of vaginal pessaries on symptoms associated with pelvic organ prolapse.
        Obstet. Gynecol. 2006; 108: 93-99
        • Abdool Z.
        • Thakar R.
        • Sultan A.H.
        • Oliver R.S.
        Prospective evaluation of outcome of vaginal pessaries versus surgery in women with symptomatic pelvic organ prolapse.
        Int Urogynecol. J. Pelvic Floor Dysfunct. 2010; 16
        • Cundiff G.W.
        • Weidner A.C.
        • Visco A.G.
        • Bump R.C.
        • Addison W.A.
        A survey of pessary use by members of the American urogynecologic society.
        Obstet. Gynecol. 2000; 95: 931-935
        • Brincat C.
        • Kenton K.
        • Pat Fitzgerald M.
        • Brubaker L.
        Sexual activity predicts continued pessary use.
        Am. J. Obstet. Gynecol. 2004; 191: 198-200
        • Sarma S.
        • Ying T.
        • Moore K.H.
        Long-term vaginal ring pessary use: discontinuation rates and adverse events.
        BJOG. 2009; 116: 1715-1721
        • Weber A.M.
        • Walters M.D.
        • Piedmonte M.R.
        Sexual function and vaginal anatomy in women before and after surgery for pelvic organ prolapse and urinary incontinence.
        Am. J. Obstet. Gynecol. 2000; 182: 1610-1615
        • Rogers R.G.
        • Kammerer-Doak D.
        • Darrow A.
        Does sexual function change after surgery for stress urinary incontinence and/or pelvic organ prolapse? A multicenter prospective study.
        Am. J. Obstet. Gynecol. 2006; 195: e1-e4
        • Ghezzi F.
        • Serati M.
        • Cromi A.
        • Uccella S.
        • Triacca P.
        • Bolis P.
        Impact of tension-free vaginal tape on sexual function: results of a prospective study.
        Int. Urogynecol. J. Pelvic Floor Dysfunct. 2005; 17: 54-59
        • Mazouni C.
        • Karsenty G.
        • Bretelle F.
        • Bladou F.
        • Gamerre M.
        • Serment G.
        Urinary complications and sexual function after the tension-free vaginal tape procedure.
        Acta Obstet. Gynecol. Scand. 2004; 83: 955-961
        • Helstrom L.
        • Nilsson B.
        Impact of vaginal surgery on sexuality and quality of life in women with urinary incontinence or genital descensus.
        Acta Obstet. Gynecol. Scand. 2005; 84: 79-84
        • Rhodes J.C.
        • Kjerulff K.H.
        • Langenberg P.W.
        • et al.
        Hysterectomy and sexual functioning.
        JAMA. 1999; 282: 1934-1947
        • Thakar R.
        • Sultan A.H.
        Hysterectomy and pelvic organ dysfunction.
        Best Pract. Res. Clin. Obstet. Gynaecol. 2005; 19 (Epub 2005 Feb 12): 403-418
        • Weber A.M.
        • Walters M.D.
        • Piedmonte M.R.
        • Ballard L.A.
        Anterior colporrhaphy: a randomized trial of three surgical techniques.
        Am. J. Obstet. Gynecol. 2001;
        • Kahn M.A.
        • Stanton S.L.
        Posterior colporrhaphy: its effects on bowel and sexual function.
        Br. J. Obstet. Gynaecol. 1997; 104: 82-86
        • Jeffcoate T.N.
        Posterior colpoperineorrhaphy.
        Am. J. Obstet. Gynecol. 1959; 77: 490-502
        • Haase P.
        • Skibsted L.
        Influence of operations for stress incontinence and/or genital descensus on sexual life.
        Acta Obstet. Gynecol. Scand. 1988; 67: 659-661
        • Porter W.E.
        • Steele A.
        • Walsh P.
        • et al.
        The anatomic and functional outcomes of defect specific rectocele repairs.
        Am. J. Obstet. Gynecol. 1999; 181: 1353-1359
        • Kenton K.
        • Shott S.
        • Brubaker L.
        Outcome after rectovaginal fascia reattachment for rectocele repair.
        Am. J. Obstet. Gynecol. 1999; 181: 1360-1364
        • Milani R.
        • Salvatore S.
        • Soligo M.
        • Pifarotti P.
        • Meschia M.
        • Cortese M.
        Functional and anatomical outcome of anterior and posterior vaginal prolapse repair with prolene mesh.
        BJOG: Int. J. Obstet. Gynaecol. 2005; 112: 107-111
        • Holley R.L.
        • Varner R.E.
        • Gleason B.P.
        • et al.
        Sexual function after sacrospinous ligament fixation for vaginal vault prolapse.
        J. Reprod. Med. 1996; 41: 355-358
        • Goldberg R.P.
        • Tomezsko J.E.
        • Winkler H.A.
        • et al.
        Anterior or posterior sacrospinous vaginal vault suspension: long-term anatomic and functional evaluation.
        Obstet. Gynecol. 2001; 98: 199-204
        • Paraiso M.F.R.
        • Ballard L.A.
        • Walters M.
        • et al.
        Pelvic support defects and visceral and sexual function in women treated with sacrospinous ligament suspension and pelvic reconstruction.
        Am. J. Obstet. Gynecol. 1996; 175: 1423-1431
        • Nieminen K.
        • Huhtala H.
        • Heinonen P.K.
        Anatomic and functional assessment and risk factors of recurrent prolapse after vaginal sacrospinous fixation.
        Acta Obstet. Gynecol. Scand. 2003; 82: 471-478
        • Benson J.T.
        • V&amp Lucente
        • McClellan E.
        Vaginal versus abdominal reconstructive surgery for the treatment of pelvic support defects: a prospective randomized study with long-term outcome evaluation.
        Am. J. Obstet. Gynecol. 1996; 175: 1418-1421
        • Maher C.F.
        • Qatawneh A.M.
        • Dwyer P.L.
        • et al.
        Abdominal sacral colpopexy or vaginal sacrospinous colpopexy for vaginal vault prolapse: a prospective randomized study.
        Am. J. Obstet. Gynecol. 2004; 190: 20-26
        • Blandon R.E.
        • Gebhart J.B.
        • Trabuco E.C.
        • Klingele C.J.
        Int. Urogynecol. J. Pelvic Floor Dysfunct. 2009; (Epub ahead of print)
        • Meyer I.
        • McGwin G.
        • Swain T.A.
        • Alvarez M.D.
        • Ellington D.R.
        • Richter H.E.
        Synthetic graft augmentation in vaginal prolapse surgery: long-term objective and subjective outcomes.
        J. Minim. Invasive Gynecol. 2016; (pii: S1553-4650(16)00117-5. [Epub ahead of print])https://doi.org/10.1016/j.jmig.2016.02.014
        • Carey M.
        • Higgs P.
        • Goh J.
        • Lim J.
        • Leong A.
        • Krause H.
        • Cornish A.
        BJOG. Sep. 2009; 116: 1380-1386
        • Nieminen K.
        • Hiltunen R.
        • Heiskanen E.
        • Takala T.
        • Niemi K.
        • Merikari M.
        • Heinonen P.K.
        Int. Urogynecol. J. Pelvic Floor Dysfunct. 2008; 19: 1611-1616
        • Baber R.J.
        • Panay N.
        • Fenton A.
        2016 IMS Recommendations on women’s midlife health and menopause hormone therapy.
        Climacteric. 2016; 19: 109-150
        • Suckling J.
        • Lethaby A.
        • Kennedy R.
        Local oestrogen for vaginal atrophy in postmenopausal women.
        Cochrane Database Syst. Rev. 2006; 4 (CD001500)
        • Lowenstein L.
        • Gamble T.
        • Deniseiko Sanses T.V.
        • van Raalte H.
        • Carberry C.
        • Jakus S.
        • Kambiss S.
        • McAchran S.
        • Pham T.
        • Aschkenazi S.
        • Hoskey K.
        • Kenton K.
        Sexual function is related to body image perceptionin women with pelvic organ prolapse.
        J. Sex. Med. 2009; 6: 2286-2291
        • Thompson J.C.
        • Rogers R.G.
        Surgical management for pelvic organ prolapse and its impact on sexual function.
        Sex. Med. Rev. 2016; 4: 213-220