Sexual function after surgery for stress urinary incontinence and/or pelvic organ prolapse: a multicenter prospective study.

Abstract

The purpose of this study was to assess sexual function in women after surgery for stress urinary incontinence and/or pelvic organ prolapse (UI/POP) at 3 and 6 months with the Pelvic Organ Prolapse Urinary Incontinence Sexual Questionnaire (PISQ). Of 269 eligible women participating in a trial of prophylactic antibiotic use with suprapubic catheters, 102 (37.9%) agreed to participate in a sexual function study. Women underwent a variety of anti-incontinence and reconstructive surgeries. Sexual function and urinary incontinence were assessed preoperatively and at 3 and 6 months postoperatively with the PISQ and Incontinence Impact Questionnaires (IIQ-7). Paired t tests compared changes over time. Logistic regression compared worsening PISQ vs other variables. Generalized McNemar's test compared individual questions pre- and postoperatively. Significance was set at P <.05. Mean age was 47.1 (23 to 85) years, and 64% of women were premenopausal. Seventy-five (74%) women completed questionnaires at 3 or 6 months. Sexual function scores declined after surgery despite improvement in IIQ-7 scores (PISQ=86 vs 78, P <.001; IIQ-7=52 vs 13, P <.001). Behavioral Emotive domain scores worsened at 3 to 6 months compared with preoperative scores, while the Physical domain improved (all P <.001). Worsening PISQ scores were independent of age, type of surgery, hysterectomy, complications, or hormonal status (logistic regression, all P <.05). Sexual function scores in women after surgery for UI/POP do not improve despite improvement of incontinence at 3 to 6 months after surgery.