Female sexual function outcomes in patients operated for pelvic floor dysfunction: Comparison of synthetic mesh with native tissue repair

Abstract

Objectives: We aimed to evaluate the impact of urogynecologic mesh implantations on sexual function using female sexual function index (FSFI) questionnaire Materials and Methods: In this cross-sectional retrospective study, a total of 187 patients which found to have pelvic organ prolapse or stress urinary incontinence (SUI) surgery were investigated between 2015 and 2022. Patients whose main complaint was SUI and had tension free vaginal tape operation (n=21) or transobturator tape operation (n=17) constituted the “Midurethral mesh group” (n=38). Those who had cystocele repair with double obturator trapezoid mesh formed the “Cystocele repair with mesh’’ group (n=35). Patients who had cystocele repair with natural tissue repair without any mesh implant in the vagina or elsewhere in the pelvis constituted the “Natural tissue repair’’ group (n=79). The patients were informed about the study and their consent was obtained. Results: The mean time elapsed since surgery till FSFI measurement was 32±6.5 months in Midurethral Mesh group; 34±7.1 months in the “Cystocele repair with mesh group and 33±7 months in the natural tissue repair group (p>0.05). Total FSFI scores 22.8±6.8, 22.2±7.5, 22.5±7.9 and the frequency of patient with scores lower than 26.5, which is the cut-off for disfunction, was 27 (71.1%), 20 (57.1%) and 47 (59.5%) similar in the three groups (p>0.05). The FSFI subdomain scores such as desire, arousal, lubrication, orgasm, satisfaction, pain was similar in the three groups (p>0.05 for all comparisons). Discussion: Our study demonstrated that surgical repair of symptomatic pelvic organ prolapse and SUI surgery using mesh implants or natural tissue repair had similar results of major parameters of sexual function after surgery.