Kole, EmreAkar, BertanDeniz, AlparslanKole, Merve CakirAslan, ErdoganCaliskan, Eray2026-01-242026-01-2420250364-216X1432-5241https://doi.org/10.1007/s00266-025-04899-5https://hdl.handle.net/20.500.12868/5503BackgroundFemale sexual dysfunction is believed to be associated with pelvic floor dysfunction in most cases. However, correcting prolapse does not always necessarily correct sexual function. The reason for this might be secondary to disregarding anatomically relevant structures during surgical interventions. We aimed to demonstrate that posterior vaginal tightening approach avoiding anteriorly located structures, such as clitoral complex, would yield better results in terms of sexual function.MethodsFifty-seven postmenopausal women with primary complaints of vaginal laxity and Grade I and II prolapse were operated. All patients received posterior vaginal tightening operation, and a cervical ring repair was utilized when indicated (n:25). Perineal repair was done if there was any defect (n:13). Levator plication is not done in any patients. FSFI (Turkish Version) was applied to each patient prior to surgery and at 6th month postoperatively. A Likert-type scale is also utilized to assess the patient satisfaction from the procedures.ResultsAll the domains and the total score of FSFI were observed to be improved. Only the improvement in the pain domain scores was not statistically significant. Satisfaction of the patients from the surgery on a Likert scale was so as to: very satisfied 27 (47.4%), satisfied 12 (21.1%), neither satisfied nor dissatisfied 8 (14%), dissatisfied 5 (8.8%), very dissatisfied 1(1.7%).ConclusionSexual function of women with vaginal laxity can be improved when vulvovaginal erotogenic complex is not disrupted. This can be achieved via a posterior approach while maintaining successful anatomic correction of both posterior and anterior compartments.Level of Evidence IIIThis journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.eninfo:eu-repo/semantics/openAccessFemale sexual function indexVaginal laxityCervical ring repairPosterior vaginal tighteningArticle10.1007/s00266-025-04899-5492161906195403799262-s2.0-105005095427Q1WOS:001489308800001Q1