Impact of vaginal surgery on sexuality and quality of life in women with urinary incontinence or genital descensus

Aim. To study the effect of vaginal surgery for urinary incontinence and genital descensus on sexual function and quality of life. Methods. The day before surgery, 118 women, of whom 41 were admitted for urinary incontinence and 77 for genital descensus, accepted to complete a questionnaire containing questions of uterovaginal symptoms, quality of life, and sexuality. One year later, 101 women, of them 88 were sexually active, accepted to complete the same questionnaire by mail. Results. The women reported improvement in two different scales for quality of life, and there was no difference between surgery for genital descensus and that for urinary stress incontinence. The total score for sexual variables was deteriorated, and the mean frequency of sexual intercourse was reduced. Among women with genital descensus, 14% experienced more urinary incontinence and 13% more dyspareunia after the operation. Conclusion. Although pelvic floor disorders are known to impair sexual function, there was no improvement in sexuality after surgery for urinary incontinence or genital descensus. On the contrary, it seems that sexual function might deteriorate and dyspareunia get worse after vaginal surgery. The explanation for this might be vulnerability to disturbance of vaginal nerve and blood supply of the vaginal wall resulting in impaired sexual arousal and lubrication.