Investigation of the effects of different surgical procedures for pelvic organ prolapse on sexual function and partner satisfaction: A retrospective observational study

Abstract

This study evaluates the impact of different surgical methods on sexual function and partner satisfaction in women with isolated apical pelvic organ prolapse. It compares uterus-sparing procedures (laparoscopic lateral mesh suspension [LLMS] and laparoscopic uterosacral ligament suspension [LUSLS]) with vaginal hysterectomy (VH) and bilateral sacrospinous ligament fixation (SSLF). This retrospective study included 20 patients with isolated apical uterine prolapse between March 2020 and March 2022. Patients were divided into 2 groups: Group 1 underwent LLMS and LUSLS, while Group 2 received VH and SSLF. Preoperative and postoperative sexual function was assessed using the Female Sexual Function Index, Quality of Sexual Experience Scale, Pelvic Organ Prolapse Symptom Score, and Female Genital Self-Image Scale. Partner sexual function was evaluated using the International Erectile Dysfunction Index. Both groups showed significant postoperative improvements in sexual function, with Group 1 demonstrating greater enhancement across all Female Sexual Function Index subdomains. Although vaginal length decreased in both groups, no significant difference was observed between them. Partner erectile function scores were significantly higher in Group 1, which also showed better overall sexual satisfaction. Uterus-sparing surgeries, particularly LLMS and LUSLS, lead to better sexual function, partner satisfaction, and recovery compared to VH with SSLF. Preserving the uterus and cervix may help maintain sexual function and improve patient outcomes, emphasizing the importance of anatomical and functional preservation in pelvic organ prolapse surgery.