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

Among 627 women who were sexually active or inactive due to fear of dyspareunia at baseline, dyspareunia decreased from 29.0% to 10.0% at 12 months after pelvic organ prolapse surgery (OR 0.3, 95% CI

Effect: improvement; OR 0.3; CI: 95% CI 0.2 – 0.4

De novo dyspareunia occurred in 17 of 445 (3.8%) women who were sexually active without pain at baseline. Only 1 of the 17 (6%) women who experienced de novo dyspareunia had a mesh or graft augmented

Effect: adverse; 3.8% (17/445)

No surgical approach — transvaginal native tissue repair, transvaginal mesh or graft augmented repair, or abdominal sacrocolpopexy — was significantly associated with postoperative dyspareunia at 12 m

Effect: null; No significant association on multivariable regression

Baseline dyspareunia was the only preoperative factor significantly associated with postoperative dyspareunia at 12 months on multivariable logistic regression (adjusted OR 7.8, 95% CI 4.2-14.4). No o

Effect: decline; adjusted OR 7.8; CI: 95% CI 4.2 – 14.4

Overall sexual activity rates increased from 57.3% at baseline to 62.8% at 12 months after prolapse surgery (OR 1.2, 95% CI 1.1-1.4). Of women not sexually active at baseline, 25.4% (101/398) became s

Effect: improvement; OR 1.2; CI: 95% CI 1.1 – 1.4

A smaller postoperative genital hiatus measurement on POP-Q exam was associated with dyspareunia at 12 months (location shift −0.5, 95% CI −0.5 – 0.0). Bothersome vaginal bulge (OR 2.1, 95% CI 1.0-4.2

Effect: decline; location shift −0.5; CI: 95% CI −0.5 – 0.0