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Paper 40: Sexual Satisfaction Before and After Sacral Colpopexy

Culligan, P J.*; Goldsmith, L J.; Blackwell, L; Tate, S B.

Journal of Pelvic Medicine and Surgery: 2005 - Volume 11 - Issue - p S19-S20
doi: 10.1097/01.spv.0000176115.63866.5e
Paper Presentations: AUGS Abstracts: 2005 26th Annual Scientific Meeting of The American Urogynecologic Society

*Atlantic Health System, Morristown, NJ; †University of Louisville HSC, Louisville, KY

Disclosure – Grant/Research Support: Mentor: P.J. Culligan; Ethicon: P.J. Culligan; Consultant: CR Bard - Culligan, Tate; Gynecare - Culligan; Speaker's Bureau: CR Bard: P.J. Culligan, S. B. Tate; Novartis: P.J. Culligan; Gynecare: P.J. Culligan; Eli Lilly: P.J. Culligan; Pfizer: P.J. Culligan; Mentor: S.B. Tate

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To describe the preoperative and postoperative sexual satisfaction among women following sacral colpopexy. Specifically, we sought to answer 3 questions: Was preoperative or postoperative sexual satisfaction correlated with degree of pelvic organ prolapse?; 2) Did sexual satisfaction improve after surgery?; and 3) Did sexual satisfaction differ between women who received synthetic or biologic graft material?

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This information was collected as part of a double-blinded, randomized controlled trial comparing synthetic mesh (n=54) and cadaveric fascia lata (n=46) for sacral colpopexy. Only the surgical team was aware of the patients' group assignments. All outcome measures were obtained by a single independent observer who was blinded as to which material was used. The objective (ie POP-Q) findings from that study were previously reported.1 Subjective endpoints were collected preoperatively and at various postoperative intervals. Here we are reporting information derived from one of those endpoints - a validated pelvic organ prolapse/urinary incontinence-specific sexual function questionnaire (PISQ) administered preoperatively and again 12 months after surgery. The PISQ consists of 31 questions answered on a Likert scale –such that higher scores correlate with greater sexual satisfaction. The highest possible score is 124. Only those patients with completed pre- and postoperative questionnaires were included in the analysis. The paired T-test was used to compare mean pre- and postoperative PISQ scores. Repeated measures ANOVA was used to determine whether there was a difference between the mesh and fascia groups. Spearman correlations were used to determine whether the PISQ scores correlated with the prolapse “leading edge” (i.e. worst POP-Q point measurement). Significance was defined at P = 0.05 (2 tailed test).

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Twenty percent of the patients were not sexually active either before or after the operation –and were therefore excluded from subsequent analyses. Among the remaining 80 patients, the mean preoperative and postoperative PISQ scores were 76.7 and 71.0 respectively (P=0.27). The preoperative PISQ score did not correlate with the preoperative POP-Q leading edge (r=−0.1, P=0.37). Likewise, there was no correlation between postoperative POP-Q leading edge and PISQ scores (r=−0.05, P=0.67). There were no PISQ score differences between women who received synthetic mesh or fascia lata (P=0.2).

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As measured by the PISQ, sexual satisfaction did not change following the sacral colpopexy procedure.

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1. Culligan PJ, Blackwell L, Goldsmith LJ, Rogers A, Heit MH. A double-blind, randomized controlled trial comparing solvent-dehydrated cadaveric fascia lata and polypropylene mesh for sacral colpopexy. AUGS / SGS Joint Scientific Meeting, 2004.
© 2005 Lippincott Williams & Wilkins, Inc.