Changes in sexual function after treatment for prolapse are related to the improvement in body image perception

Introduction: In a previous study, sexual function was related to a woman's self-perceived body image and degree of bother from pelvic organ prolapse (POP). Aims.: To evaluate sexual function, prolapse symptoms, and self-perceived body image 6 months following treatment for POP and to explore differences in body image perception and sexual function following conservative and surgical treatment for POP. Methods.: After institutional review board approval, consecutive women with ≥stage II POP were invited to participate. In addition to routine urogynecologic history and physical examination, including Pelvic Organ Prolapse Quantification (POP-Q), the participants completed three validated questionnaires before, and 6 months after, treatment for POP: Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire, Modified Body Image Perception Scale and Prolapse subscale of Pelvic Floor Distress Inventory to assess condition specific bother from POP. Main Outcome Measures.: Changes in sexual function and body image perception following treatment for POP. Results.: A total of 235 women with a mean age of 62 ± 12 years returned for a 6-month follow-up. The majority of our participants had surgical repair for POP (88%). At 6-month follow-up visits, the patients reported significant improvement in sexual function from baseline (33 ± 0.6 vs. 43 ± 0.8, respectively P < 0.0001). Improvement in sexual function, as measured by PISQ-12, was not significant among sexually active patients treated with a pessary compared with those treated surgically (-2.5 ± 5.5 vs. 11.5 ± 1, respectively P < 0.0001). A multivariate linear regression model demonstrated that body mass index and changes in body image perception were the only independent factors associated with changes in PISQ score following POP treatment (β = -0.5, P < 0.01 and β = -0.4, P < 0.03, respectively). Conclusions.: Resolution of POP symptoms after treatment improves women's self-perceived body image and sexual function. Not surprisingly, pessary is less effective in improving sexual function compared with surgical repair of copy; 2009 International Society for Sexual Medicine.