scholarly journals Surgery for pelvic organ prolapse and stress urinary incontinence and female sexual functions: A quasi-experimental study

2021 ◽  
Vol 37 (4) ◽  
Author(s):  
Saida Abrar ◽  
Raheela Mohsin ◽  
Huda Saleem
Keyword(s):  
Experimental Study ◽  
Urinary Incontinence ◽  
Pelvic Organ Prolapse ◽  
Stress Urinary Incontinence ◽  
Sexual Function ◽  
Pelvic Floor ◽  
Pelvic Floor Disorders ◽  
Pelvic Organ ◽  
Pelvic Floor Repair ◽  
Quasi Experimental

Objectives: To assess the effect of pelvic organ prolapse (POP) and/or stress urinary incontinence (SUI) on various domains of female sexual functions in patients before and after reconstructive surgery for these pelvic floor disorders. Methods: We conducted a quasi-experimental study of 126 women aged 25-65 years, presenting with POP / SUI, from January 1st 2019 to December 31st 2019 at Aga Khan University Hospital. POP surgery was performed only in patients with symptomatic POP ≥ stage 2 according to POP-Q (quantification). Sexual functions were assessed using Female Sexual Function Index (FSFI) questionnaire, among sexually active women at baseline and 18 months after surgery. Results: Mean age of the participants was 51.6, with a mean parity of four. Out of 126 patients, 31 patients underwent vaginal hysterectomy, pelvic floor repair and mid-urethral sling (MUS), 55 had vaginal hysterectomy with pelvic floor repair, 12 women had only pelvic floor repair and 10 patients had uterine suspension surgery for prolapse, while 18 patients underwent MUS operation alone for SUI. There was a statistically significant difference in female sexual functions after surgery for POP and/or SUI (p<0.01). This improvement was observed in both total and individual scores of each domain of FSFI with an overall improvement in sexual function from a mean of 18.5 pre-surgery to 20.8 post-surgery. Conclusions: This study reveals that women sexual functions are affected by POP and SUI and improve remarkably after reconstructive surgeries for these pelvic floor disorders. doi: https://doi.org/10.12669/pjms.37.4.3892 How to cite this:Abrar S, Mohsin R, Saleem H. Surgery for pelvic organ prolapse and stress urinary incontinence and female sexual functions: A quasi-experimental study. Pak J Med Sci. 2021;37(4):---------. doi: https://doi.org/10.12669/pjms.37.4.3892 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Sexual function in women with pelvic floor disorders

2013 ◽  
Vol 7 (9-10) ◽  
pp. 199 ◽  
Author(s):  
Rebecca G. Rogers
Keyword(s):  
Urinary Incontinence ◽  
Pelvic Organ Prolapse ◽  
Stress Urinary Incontinence ◽  
Sexual Function ◽  
Pelvic Floor ◽  
Pelvic Floor Disorders ◽  
Pelvic Floor Dysfunction ◽  
Pelvic Organ ◽  
The Impact

Pelvic floor disorders (PFDs) can impact sexual function. This summary provides an overview of the impact of stress urinary incontinence and pelvic organ prolapse and their treatments on sexual function. In general, interventions that successfully address PFDs will generally improve sexual function as well. However, there are patients whose sexual function will remain unchanged despite treatment, and a small but significant minority who will report worsened sexual function following treatment for their pelvic floor dysfunction.

Synthetic Mesh Used in Gynecologic Reconstructive Surgery for Pelvic Floor Disorders

2017 ◽  
Vol 752 ◽  
pp. 59-63
Author(s):  
Elvira Brătilă ◽  
Petre Brătilă ◽  
Diana Comandașu ◽  
Monica Cîrstoiu ◽  
Roxana Bohîlțea ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Pelvic Organ Prolapse ◽  
Stress Urinary Incontinence ◽  
Pelvic Floor ◽  
Pelvic Floor Disorders ◽  
Pelvic Organ ◽  
Synthetic Mesh ◽  
Effective Porosity ◽  
Apical Prolapse ◽  
Mesh Surgery

Pelvic floor disorders including stress urinary incontinence and pelvic organ prolapse represent a challenge for gynecologist or urogynecologist even nowadays. Conservative treatment for these conditions proves its effectiveness only in few cases selected from early forms of incontinence or prolapse the most cases being solved surgically. The introduction of the procedure imagined by Petros and Ulmsten, known as TVT (Trans Vaginal Tape) in which the medium urethra is supported by a synthetic tape produced in 1996 a revolution in the surgical treatment of stress urinary incontinence. Radical changes also appeared in pelvic organ prolapse surgery extrapolating the hernia repair procedure by using synthetic mesh. After nearly 20 years of experience the mesh surgery is today a common practice in urogynecology. Between 2011 and 2015 we operated in private practice a total number of 297 cases of which 187 cases of stress urinary incontinence and 110 cases of pelvic organ prolapse. From these 86 (78,1%) cases were represented by cystoceles, associated with early apical prolapse or rectoceles, 18 (16,3%) cases by apical prolapse (grade III-IV) and 6 (5,4%) cases by posterior compartment prolapse alone. We performed mesh surgery in 32 (29%) cases represented mainly by anterior compartment prolapse. In 6 (18,7%) cases we founded mesh extrusion which required partially resection. In two cases we performed large resection of anterior vaginal wall required grafting with acellular second generation graft. In all cases with mesh extrusion the biomechanical analysis revealed significant decrease in effective porosity of the mesh due to excessive tensioning or folding of the mesh. The use of mesh in stress urinary incontinence and pelvic organ prolapse represent a justified alternative in selected cases. The specific complications due to meshes are more frequent in prolapse surgery compared to stress urinary incontinence. In all cases altered effective porosity due to technical defects in surgery represents the leading cause.

Pessary Management for the General Gynecologist

2020 ◽  
Author(s):  
Molly Dahl ◽  
Aldene Zeno
Keyword(s):  
Urinary Incontinence ◽  
Pelvic Organ Prolapse ◽  
Stress Urinary Incontinence ◽  
Pelvic Floor ◽  
Pelvic Floor Disorders ◽  
Pelvic Organ ◽  
Outpatient Setting ◽  
Primary Literature

Pessaries are vaginal support devices that come in a variety of shapes and sizes. The purpose of this book chapter is to describe the indications, management, outcomes, and complications associated with pessaries for the general practitioner. A review of the pessary is provided. Information is based on primary literature, systematic reviews, and current expert opinion. Pessaries are most commonly used for pelvic organ prolapse and stress urinary incontinence. They are easy to place and have minimal serious side effects. The majority of women can be successfully fitted with a pessary in the outpatient setting. Pessaries improve vaginal bulge symptoms, urinary complaints, body image, and quality of life for women with pelvic floor disorders. Therefore, pessaries are safe and effective options for the management of pelvic floor disorders and should be offered to patients with pelvic organ prolapse and stress urinary incontinence. This review contains 5 tables, 6 figures and 30 references. Key Words: conservative management, Gellhorn pessary, pelvic organ prolapse (POP), ring pessary, SUI, urinary urgency, vaginal exam 

scholarly journals Incidence and characteristics of de novo stress urinary incontinence after pelvic organ prolapse vaginal repair

2021 ◽  
Author(s):  
Suskhan Djusad ◽  
Ihya Ridlo Nizomy ◽  
Surahman Hakim ◽  
Tyas Priyatini ◽  
Fernandi Moegni ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Pelvic Organ Prolapse ◽  
Stress Urinary Incontinence ◽  
Pelvic Floor ◽  
De Novo ◽  
Stress Test ◽  
Pelvic Organ ◽  
Pelvic Floor Reconstruction ◽  
De Novo Sui ◽  
National Referral Hospital

BACKGROUND Some patients who undergo pelvic floor reconstruction for pelvic organ prolapse (POP) may experience a de novo stress urinary incontinence (SUI) postoperatively. We aimed to investigate the incidence and characteristics of de novo SUI in patients who underwent pelvic floor reconstruction at the national referral hospital in Indonesia. METHODS This cross-sectional study evaluated 108 patients who underwent pelvic floor reconstruction due to POP between January 2016 and December 2017. Per the inclusion criteria, 75 women were enrolled using a consecutive sampling. The incidence of de novo SUI was determined 6–12 months postoperatively using the Indonesian version of the questionnaire for urinary incontinence diagnosis and objectively using the cough stress test during gynecologic examination after a negative preoperative prolapse reduction stress test. RESULTS The average age, parity, body mass index, and years since menopause onset were 56.17 (4.67) years, 3.17 (1.07), 28.58 (5.18) kg/m2, and 12.8 (7.0) years, respectively. De novo SUI was seen in 8.0% (6 of 75) patients at 6–7 months postoperatively, with 3 (50.0%) had severe POP and 3 (50.0%) had a mild POP. Most of these patients (4 of 6, 66.7%) had undergone procedures other than colpocleisis for POP reconstruction. CONCLUSIONS The incidence of de novo SUI after gynecologic surgery for POP at a national referral hospital in Indonesia is 8%. Most patients were aged <60 years, had a parity of <4, were nonobese, were menopausal, and had diabetes.

scholarly journals Identification of the Pelvic Organ Prolapse/Incontinence Sexual Questionnaire—IUGA Revised (PISQ-IR) Cutoff Scores for Impaired Sexual Function in Women with Pelvic Floor Disorders

2019 ◽  
Vol 9 (1) ◽  
pp. 13 ◽  
Author(s):  
Magdalena Emilia Grzybowska ◽  
Konrad Futyma ◽  
Dariusz Wydra
Keyword(s):  
Pelvic Organ Prolapse ◽  
Sexual Dysfunction ◽  
Sexual Function ◽  
Pelvic Floor ◽  
Roc Curve ◽  
Pelvic Floor Disorders ◽  
Pelvic Organ ◽  
Summary Score ◽  
Operating Characteristics ◽  
Cutoff Scores

The aim of this cross-sectional study was to determine the cutoff scores for sexual dysfunction in disease-specific Pelvic Organ Prolapse/Incontinence Sexual Questionnaire—IUGA Revised (PISQ-IR) for women with pelvic floor disorders (PFD). Medical history and urogynecological data of 521 women with PFD were collected. The subjects provided information about their sexual activity and completed Female Sexual Function Index (FSFI) and PISQ-IR questionnaires. Sexually active (SA) women were further analyzed and categorized using their FSFI scores: <26.55—sexual dysfunction, >26.55—no sexual dysfunction. Receiver operating characteristics (ROC) curve tested how well PISQ-IR allowed to discriminate between patients with and without sexual disorders. Area under curve (AUC) was calculated to measure the PISQ-IR Summary Score efficiency in the prediction. The cutoff values which minimalize (1-specifity) and maximize sensitivity were selected. In the analyzed cohort, 250 (48%) women were SA and a total of 226 SA were recruited for the study: 143 (63.3%) with <26.55 FSFI and 83 (36.7%) with >26.55 FSFI (response rate: 90.4%). Using ROC curve analysis, PISQ-IR Summary Score of 2.68 was determined to be the optimal cutoff for distinguishing between dysfunctional and nondysfunctional women (AUC = 0.85), allowing to diagnose sexual dysfunction in SA women with PFD, with 90% sensitivity and 71% specificity.

scholarly journals A new measure of sexual function in women with pelvic floor disorders (PFD): the Pelvic Organ Prolapse/Incontinence Sexual Questionnaire, IUGA-Revised (PISQ-IR)

2013 ◽  
Vol 24 (7) ◽  
pp. 1091-1103 ◽  
Author(s):  
R. G. Rogers ◽  
T. H. Rockwood ◽  
M. L. Constantine ◽  
R. Thakar ◽  
D. N. Kammerer-Doak ◽  
...  
Keyword(s):  
Pelvic Organ Prolapse ◽  
Sexual Function ◽  
Pelvic Floor ◽  
Pelvic Floor Disorders ◽  
Pelvic Organ

scholarly journals Symptomatic pelvic floor disorders and its associated factors in South-Central Ethiopia

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0254050
Author(s):  
Eskedar Demissie Beketie ◽  
Wubishet Tesfaye Tafese ◽  
Zebene Mekonnen Assefa ◽  
Fantahun Walle Berriea ◽  
Genet Asfaw Tilahun ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Urinary Incontinence ◽  
Pelvic Organ Prolapse ◽  
Fecal Incontinence ◽  
Pelvic Floor ◽  
Associated Factors ◽  
Pelvic Floor Disorders ◽  
Pelvic Organ ◽  
Weight Lifting ◽  
South Central

Introduction Pelvic floor disorders (PFD) are gynecologic health problems containing a wide variety of clinical problems; the most prevalent problems are pelvic organ prolapse, fecal incontinence, and urinary incontinence. It is a significant women’s health problem for both developed and developing countries. One in five women in Ethiopia experiences at least one major type of pelvic floor disorders. Despite the severity of the problem, due attention was not given, and no study has been conducted on pelvic floor disorders in the Gurage Zone. Objective To determine the prevalence and associated factors of symptomatic pelvic floor disorders among women living in Gurage Zone, SNNPR, Ethiopia, 2020. Methodology Community-based cross-sectional study was conducted from February to March 2020 among 542 women residing in the Gurage Zone. A multi-stage sampling method was used to select the participants. Interviewer administered, pretested questionnaires containing questions related to pelvic organ prolapse, urinary, and fecal incontinence was used. The urinary incontinence severity index questionnaire was used to assess the severity of urinary incontinence. Epi-Info x7 was used to record data, and SPSS was used to analyze the data. Binary logistic regression with 95% CI was used to explore the relationship between PFD and other independent variables. After multivariable logistic regression analysis variables with P-value less than 0.05 was used to determine significant association. Result A total of 542 participants were included in this study. Overall, 41.1% of the participants reported one or more symptoms of pelvic floor disorders. Urinary incontinence had the highest prevalence (32.8%), followed by pelvic organ prolapse (25.5%) and fecal incontinence (4.2%). History of weight lifting >10 Kg (AOR = 3.38; 95% CI: 1.99, 5.72), ≥5 vaginal delivery (AOR = 11.18; 95% CI: 1.53, 81.58), and being in menopause (AOR = 3.37; 95% CI: 1.40, 8.07) were identified as possible contributing factors in the development of a pelvic floor disorders. Conclusion The prevalence of symptomatic PFD was higher compared to other similar studies in Ethiopia. Heavy weight lifting, repetitive vaginal deliveries and menopause were factors significantly associated with PFD. Expansion of technologies and building basic infrastructures, health education on kegel exercise and promotion of family planning should be considered as a prevention strategy.

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