Sexual Activity and Dyspareunia 1 Year After Surgical Repair of Pelvic Organ Prolapse

被引:18
作者
Lukacz, Emily S.
Sridhar, Amaanti
Chermansky, Christopher J.
Rahn, David D.
Harvie, Heidi S.
Gantz, Marie G.
Varner, R. Edward
Korbly, Nicole B.
Mazloomdoost, Donna
机构
[1] UC San Diego Hlth Syst, Dept Obstet Gynecol & Reprod Sci, San Diego, CA USA
[2] RTI Int, Social Stat & Environm Sci, Res Triangle Pk, NC USA
[3] Univ Pittsburgh, Sch Med, Dept Urol, Pittsburgh, PA USA
[4] Univ Texas Southwestern Med Ctr Dallas, Dept Obstet & Gynecol, Dallas, TX 75390 USA
[5] Univ Penn, Dept Obstet & Gynecol, Philadelphia, PA 19104 USA
[6] Univ Alabama Birmingham, Dept Obstet & Gynecol, Birmingham, AL 35294 USA
[7] Brown Univ, Dept Obstet & Gynecol, Providence, RI 02912 USA
[8] Eunice Kennedy Shriver Natl Inst Child Hlth & Hum, NIH, Bethesda, MD USA
关键词
QUALITY-OF-LIFE; FLOOR DISORDERS; VAGINAL PROLAPSE; UTEROVAGINAL PROLAPSE; URINARY-INCONTINENCE; MESH HYSTEROPEXY; VAULT SUSPENSION; WOMEN; QUESTIONNAIRE; PREVALENCE;
D O I
10.1097/AOG.0000000000003992
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
OBJECTIVE: To describe sexual activity and risks for dyspareunia after pelvic organ prolapse surgery. METHODS: This was a secondary analysis of data from four randomized trials conducted between 2002 and 2018. Standard assessments and validated measures of sexual function were assessed at baseline and at 12 months postoperatively. Anterior apical surgeries were grouped by approach: transvaginal native tissue repairs, transvaginal mesh or graft-augmented repairs, and abdominal sacrocolpopexy. Additional surgeries, which included posterior repair, hysterectomy, and slings, were analyzed. Bivariate analyses and logistic regression models identified risk factors for postoperative dyspareunia. RESULTS: Of the 1,337 women enrolled in the trials, 932 had sufficient outcome data to determine dyspareunia status. Of these before surgery, 445 (47.8%) were sexually active without dyspareunia, 89 (9.6%) were sexually active with dyspareunia, 93 (10.0%) were not sexually active owing to fear of dyspareunia, and 305 (32.7%) were not sexually active for other reasons. At 12 months, dyspareunia or fear of dyspareunia was present in 63 of 627 (10.0%); occurred de novo in 17 of 445 (3.8%) and resolved in 136 of 182 (74.7%). Multivariable regression demonstrated baseline dyspareunia as the only factor associated with postoperative dyspareunia (adjusted odds ratio 7.8, 95% CI 4.2-14.4). No other factors, including surgical approach, were significantly associated with postoperative dyspareunia. Too few had de novo dyspareunia to perform modeling. CONCLUSION: Dyspareunia is common in one in five women before undergoing prolapse surgery. Surgical repair resolves dyspareunia in three out of four women with low rates of de novo dyspareunia at less than 4%. Preoperative dyspareunia appears to be the only predictor of postoperative dyspareunia.
引用
收藏
页码:492 / 500
页数:9
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