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Long-Term Sexual Function After Obstetric Anal Sphincter Injuries

O'Shea, Michele, S., MD, MPH*; Lewicky-Gaupp, Christina, MD*†; Gossett, Dana, R., MD, MSCI

Female Pelvic Medicine & Reconstructive Surgery: March/April 2018 - Volume 24 - Issue 2 - p 82–86
doi: 10.1097/SPV.0000000000000466
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Objectives Obstetric anal sphincter injuries (OASIS) are associated with severe short and long-term morbidities, although little is known about the long-term sexual function or satisfaction of women and partners of women with history of OASIS. The objective of this study was to describe the long-term sexual function and satisfaction of women who previously sustained OASIS and to assess sexual satisfaction among their male partners.

Methods This was a follow-up study of participants enrolled in the For Optimal Recovery: Care After Severe Tears (FORCAST) prospective cohort study of women with a history of OASIS after delivery of a full-term singleton infant between 2011 and 2013. A total of 47 women and 25 male partners at a mean of 45 months ± 8 months after incident delivery completed online validated questionnaires assessing current sexual functioning and satisfaction. The Female Sexual Functioning Index (FSFI) was completed by female participants, whereas the Golombok-Rust Inventory of Sexual Satisfaction (GRISS) was completed by both female participants and their male partners.

Results Nearly half (47%) of women met the criteria for female sexual dysfunction according to the Female Sexual Functioning Index. One-third of women (34%) had an overall GRISS score of 5 or greater, indicating sexual dysfunction. Sixty-two percent of women had a subsequent delivery. Seven male partners (28%) met the criteria for sexual dysfunction according to the GRISS. The most problematic GRISS subscale reported by both men and women was that of infrequency of intercourse.

Conclusions Even 3 years after sustaining OASIS, up to half of women and many male partners meet the criteria for sexual dysfunction. Future studies including women without history of OASIS are needed to further investigate the role OASIS may play in the development of long-term sexual dysfunction.

Women and male partners of women with a history of obstetric anal sphincter injury may experience long-term sexual dysfunction.

From the *Division of General Obstetrics and Gynecology, Department of Obstetrics and Gynecology, †Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, IL; and ‡Division of Obstetrics, Gynecology, and Gynecologic Subspecialties, Department of Obstetrics and Gynecology, University of California, San Francisco, CA.

Correspondence: Michele O'Shea, MD, MPH, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, 250 E. Superior St, Chicago, IL 60611. E-mail:

The authors have declared they have no conflicts of interest.

This study was supported by the Evergreen Invitational Women's Health Initiative.

Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.