Body image and sexual function improve following prolapse repair - 22/08/25
, Kayla Nowak, BS b, Shawn A. Menefee, MD c, Julia K. Shinnick, MD d, Margaret Mueller, MD e, Abbigail Woll, MD f, Maria Florian-Rodriquez, MD g, Donna Mazloomdoost, MD h, Ryan Whitworth, PhD bfor the
NICHD Pelvic Floor Disorders Network
Abstract |
Background |
Body image (a woman’s perceptions and attitudes about her body) likely plays a role in pelvic organ prolapse treatment satisfaction and postoperative sexual function.
Objective |
The primary aim of this study was to describe changes in body image after surgical repair of vaginal vault prolapse. The secondary aim was to evaluate whether changes in sexual function are correlated with changes in body image.
Study Design |
This was a planned secondary analysis of a randomized three-arm trial comparing surgical approaches for vaginal vault prolapse. Women with symptomatic posthysterectomy vault prolapse were randomized to: transvaginal native tissue repair, mesh placed abdominally (sacrocolpopexy), or mesh placed transvaginally (TVM). Body image was measured using the validated Body Image in Pelvic Organ Prolapse questionnaire at baseline, 6, 12, 24, and 36 months. Sexual activity and function were measured using the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire, IUGA revised at similar time points. Longitudinal analysis for changes from baseline in mean Body Image in Pelvic Organ Prolapse score and the proportion of women who met a distribution-based estimate of the minimally important difference was performed using general mixed models for repeated measures. The same method was used as a model to predict change in sexual function based on body image.
Results |
A total of 335 women were included in the analysis: native tissue repair=123, sacrocolpopexy=107, TVM=105. Mean age was 66.1±8.5 years and a majority (242, 72%) had stage 3 prolapse. Baseline total and subscale Body Image in Pelvic Organ Prolapse scores were not significantly different by treatment arm. All arms improved by 6 months, and this improvement was sustained to 36 months with no significant differences between the groups for change in Body Image in Pelvic Organ Prolapse score nor minimally important difference–equivalent improvement. Ninety-nine (30%) women reported being sexually active at all visits, 131 (39%) reported they were not sexually active at all visits, and the remainder changed sexual activity status throughout the study. Amongst sexually active participants, there were no baseline differences in Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire, IUGA revised scores between groups (native tissue repair, 54 women, 3.2±0.7; sacrocolpopexy, 43 women, 3.3±0.7; TVM, 46 women, 3.1±0.6). In sexually active women, change in Body Image in Pelvic Organ Prolapse and Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire, IUGA revised scores were correlated at each visit and a significant association between these measures ( P < .001) remained after adjustment for baseline sexual function, site, age, surgical treatment arm, and baseline dyspareunia.
Conclusion |
Body image improves following repair of vaginal vault prolapse, regardless of the surgical approach. Improvements in body image and sexual function are positively correlated among sexually active women.
Le texte complet de cet article est disponible en PDF.Key words : body image, prolapse surgery, sexual function
Plan
| The authors report no conflict of interest. |
|
| The study was supported with the following grants from the Eunice Kennedy Shriver National Institute of Child Health and Human Development and National Institutes of Health Office of Research on Women's Health: University of Alabama Birmingham (UG1 HD041261), Brown University/Womens & Infants Hospital (UG1 HD069013), University of California at San Diego (UG1 HD054214), Duke University (UG1 HD041267), University of Texas Southwestern (UG1 HD054241), University of Pennsylvania (UG1 HD069010), University of Pittsburgh/Magee Womens Hospital (UG1 HD069006), University of New Mexico (FP1810/3RG40), RTI International (U24 HD069031), Cleveland Clinic (RTII 1606MB). |
|
| Clinical Trial Information: Identification Number NCT04201821. |
|
| This research was presented at the annual American Urogynecology Society Pelvic Floor Disorders' Week Oct. 22–25, 2024. Washington, DC. |
|
| Cite this article as: Andy UU, Nowak K, Menefee SA, et al. Body image and sexual function improve following prolapse repair. Am J Obstet Gynecol 2025;233:182.e1-12. |
Vol 233 - N° 3
P. 182.e1-182.e12 - septembre 2025 Retour au numéro
Article précédent
- Impaired fertility and perinatal outcomes in adenomyosis: insights from a novel murine model and uterine gene profile alterations during implantations
- Hanxi Zheng, Meng Liu, Qiaolian Su, Hong Li, Fuxin Wang
- Menstrual product use patterns in a large digital cohort in the United States: variations by sociodemographic, health, and menstrual characteristics
- Zifan Wang, Elizabeth Peebles, Donna D. Baird, Anne Marie Z. Jukic, Allen J. Wilcox, Christine L. Curry, Tyler Fischer-Colbrie, Jukka-Pekka Onnela, Michelle A. Williams, Russ Hauser, Brent A. Coull, Shruthi Mahalingaiah
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?