Recovering sexual satisfaction after prolapse surgery: a secondary analysis of surgical recovery.

INTRODUCTION AND HYPOTHESIS: We compared pre- and postoperative sexual function scores in sexually active women undergoing pelvic organ prolapse (POP) surgery.

METHODS: Planned secondary analysis of women enrolled in the Restricted Convalescence: Outcomes Following Urogynecologic Procedures study, a randomized trial of postoperative activity after POP surgery. All participants could return to sexual activity at 6 weeks. Participants completed the Pelvic Floor Distress Inventory (PFDI), the Patient-Reported Outcomes Measurement Information System (PROMIS) profile, and the Golombok Rust Inventory of Sexual Satisfaction (GRISS) questionnaires at baseline and 3 months. GRISS is a validated 28-item survey for heterosexual couples that contains seven subscales to assess sexual function. Higher scores represent worse sexual function.

RESULTS: Thirty-seven sexually active women were assessed. Mean age ±  standard deviation (SD) was 56 ± 11, most of whom (92%) were Caucasian; 78% had undergone minimally invasive sacrocolpopexy, and the remainder had native tissue vaginal repairs. GRISS scores improved 3 months after surgery [4.5 ± 2.6 to 3.6 ± 2.2, p < 0.001; mean decrease of 0.9, 95% confidence interval (CI) 0.36-1.36]. PFDI scores improved from 122 ± 53 at baseline to 28 ± 31 at 3 months (p < 0.001). Higher GRISS scores were correlated with higher PFDI scores (Spearman's rho = 0.35, p = 0.03) at baseline and 3 months (Spearman's rho = 0.31, p = 0.03). Several GRISS subscales improved after surgery: partner avoidance (p = 0.01), vaginismus (p = 0.02), noncommunication (p = 0.01), dissatisfaction (p = 0.03), and anorgasmia (p = 0.001). However, sexual infrequency (p = 0.08) and nonsensuality (p = 0.4) did not change. Fifty-one percent had sexual dysfunction before surgery, which decreased to 32% after surgery (p = 0.04).

CONCLUSION: Sexual function and satisfaction are significantly improved 3 months following POP surgery. Improved sexual function is correlated with improved pelvic floor symptoms.