Maintaining sexual function after pelvic floor surgery

Climacteric. 2019 Jun;22(3):236-241. doi: 10.1080/13697137.2018.1551870. Epub 2019 Jan 7.

Abstract

Sexual dysfunction in women with prolapse and incontinence is well documented in the literature, but the impact of treatment, particularly surgical correction, remains very limited and confusing. Age, on the other hand, has been shown to be an independent risk factor for deteriorating sexual function, with all aspects of the sexual function (i.e. desire, arousal, penetration, and orgasm) being affected. When combined with surgical correction of prolapse or incontinence there is potential for further worsening of sexual function, and hence this should be assessed before any pelvic floor surgery and patient expectations established. In this article the current evidence will be reviewed looking at the impact of pelvic floor dysfunction on sexual function and the effect of commonly performed surgery for these problems. Ways and means of preserving sexual function in women undergoing corrective surgery will also be investigated.

Keywords: Sexual function; female sexual dysfunction; pelvic floor dysfunction; pelvic floor surgery; pelvic organ prolapse; urinary incontinence.

Publication types

  • Review

MeSH terms

  • Female
  • Gynecologic Surgical Procedures / adverse effects
  • Humans
  • Hysterectomy
  • Muscles / physiopathology
  • Pelvic Floor / physiopathology*
  • Pelvic Floor / surgery*
  • Pelvic Organ Prolapse / surgery*
  • Postoperative Complications / physiopathology*
  • Sexual Dysfunction, Physiological / prevention & control*
  • Sexual Dysfunction, Physiological / therapy
  • Sexual Dysfunctions, Psychological / prevention & control*
  • Sexual Dysfunctions, Psychological / therapy
  • Surgical Mesh
  • Urinary Incontinence, Stress / physiopathology
  • Urinary Incontinence, Stress / surgery
  • Urologic Surgical Procedures / adverse effects