Abstrakt

Effects of uterus-preserving surgical modalities on sexual functions in total prolapsus cases

Hasan

Object?ve: To investigate sexual quality of life in uterine prolapse patients treated with hysteropexy while preserving the uterus in premenopausal period.

Materials and methods: This retrospective cohort study was conducted on 124 sexually active women whose age was between 30 and 45 and who were operated for prolapse by vaginal, abdominal, laparoscopic repair methods while preserving the uterus between May 2011 and April 2017. Women who willing to participate in the study, were filled an information form inquiring socio-demographic characteristics and Sexual Quality of Life Questionnaire-Female (SQLQ-F). Face-to-face survey method was used to assess the patient's satisfaction. Success was defined as prolapse below than stage 2, healing in preoperative symptoms, sexual relationship and post-operative pregnancy rate.

Results: One hundred and twenty four patients with pelvic organ prolapse stage 2-3 were included. The face-to-face questionnaire was conducted post-operatively 24 ± 9 months on average and quality of sexual life in the last six weeks were evulated by Sexual Quality of Life Questionnaire- Female (SQLQ-F). The SQLQ-F score of laparoscopic sacrohysteropexy was found higher than laparotomy and Sacrospinous ligament hysteropexy (p=0.011). There was found significantly difference in presence of vaginal dryness and dyspareunia among abdominal and vaginal way (p<0.001). The SQLQ-F score in women who had vaginal dryness was found lower than women who had not vaginal dryness in all surgical procedures, but significantly difference was only found in laparoscopic sacrohysteropexy group (p=0.027). There was no significantly difference found in the SQLQ-F score in women with and without dyspareunia according to the surgical procedures (p>0.05).

Conclus?ons: Sexual quality of life in laparoscopic hysteropexy is better than laparotomy and vaginal procedure. Vaginal dryness in vaginal hysteropexy negatively effects sexual quality of life. Uterus preservation options should be discussed with every premenopausal and sexually active patient before surgery for pelvic organ prolapse.