Table 2.
Sexual function and body image after vaginal prolapse surgery
| Variable | BASELINE | 6 MONTHS | 12 MONTHS | 24 MONTHS | Time (P-value)* | ULS vs. SSLF (P-value)* |
|---|---|---|---|---|---|---|
|
| ||||||
|
Sexually Active
| ||||||
| Overall | 184/346 (53.2%) | 195/331 (58.9%) | 186/317 (58.7%) | 169/305 (55.4%) | 0.65 | 0.16 |
| De novo | N/A | 27/145 (18.6%) | 28/134 (20.9%) | 37/136 (27.2%) | 0.17 | 0.19 |
| Stopped | N/A | 7/169 (4.1%) | 10/161 (6.2%) | 26/150 (17.3%) | <0.01 | 0.02 |
| ULS – Stopped | N/A | 1/84 (1.2%) | 2/80 (2.5%) | 12/76 (15.8%) | 6 vs. 12MON: 0.52 | 6MON: 0.054 |
| SSLF – Stopped | N/A | 6/85 (7.1%) | 8/81 (9.9%) | 14/74 (18.9%) | 6 vs. 24MON: <0.01 12 vs. 24MON: <0.01 |
12MON: 0.01 24MON: 0.44 |
|
| ||||||
|
Not
Active/Restricted
| ||||||
| Due to Pain | 77/312 (24.7%) | 57/283 (20.1%) | 56/281 (19.9%) | 62/270 (23.0%) | 0.63 | 0.97 |
| Due to Bulge | 106/316 (33.5%) | 59/284 (20.8%)† | 57/283 (20.1%)† | 57/278 (20.5%)† | 0.98 | 0.91 |
| Due to Incontinence | 55/313 (17.6%) | 30/286 (10.5%)† | 28/284 (9.9%)† | 32/272 (11.8%)‡ | 0.78 | >0.99 |
|
| ||||||
|
Dyspareunia§
| ||||||
| Overall Dyspareunia = PISQ-12 Questions B5 or C4 or Treatment | 77/312 (24.7%) | 31/301 (10.3%) † | 26/296 (8.8%) † | 45/275 (16.4%) † | 0.01 6 vs. 12MON: 0.64 6 vs. 24MON: 0.02 12 vs. 24MON: <0.01 |
0.14 |
| De novo Dyspareunia | N/A | 7/123 (5.7%) | 6/122 (4.9%) | 11/112 (9.8%) | 0.41 | 0.63 |
| B5: Pain during intercourse | 48/182 (26.4%) | 21/194 (10.8%) † | 14/186 (7.5%) † | 24/165 (14.5%) † | 0.12 | 0.92 |
| C4: Fear of pain | 29/130 (22.3%) | 9/107 (8.4%) † | 8/109 (7.3%) † | 15/110 (13.6%) | 0.22 | 0.20 |
| Treatment for Dyspareunia‖ | N/A | 1/352 (0.3%) | 4/341 (1.2%) | 10/319 (3.1%) | N/A | 0.21 |
|
| ||||||
|
PISQ-12
| ||||||
| N | 183 | 161 | 150 | 124 | 0.02 | 0.65 |
| Mean ± SE | 30.7 ± 0.6 | 7.1 ± 0.7¶ | 7.2 ± 0.7¶ | 5.9 ± 0.7¶ | 6 vs. 12MON: 0.87 | |
| Minimum, Maximum | 6.5, 46.0 | −11.0, 25.5 | −10.0, 29.0 | −13.6, 25.0 | 6 vs. 24MON: 0.01 12 vs. 24MON: 0.01 |
|
|
| ||||||
|
Normalized Body Image
Score
| ||||||
| N | 354 | 340 | 325 | 300 | <0.01 | 0.54 |
| Mean ± SE | 25.3 ± 0.2 | −20.7 ± 1.7¶ | −20.8 ± 1.7¶ | −17.6 ± 1.7¶ | 6 vs. 12MON: 0.85 | |
| Minimum, Maximum | 0.0, 100 | −100, 66.7 | −100, 92.6 | −100, 96.3 | 6 vs. 24MON: <0.01 12 vs. 24MON: <0.01 |
|
ULS=uterosacral ligament suspension. SSLF=sacrospinous ligament fixation. MON=Month. PISQ-12=Pelvic Organ Prolapse-Urinary Incontinence Sexual Questionnaire. NA = Not Applicable. SE=Standard error.
P-values for Time and for ULS vs. SSLF are from longitudinal generalized linear mixed models of dichotomous outcomes (sexually active, not active or restricted, and dyspareunia) or longitudinal general linear mixed models of changes from baseline for continuous outcomes (PISQ-12 and normalized body image score).
Proportion of women with the outcome is significantly different from baseline at the p<0.01 level based on the longitudinal generalized linear mixed model.
Proportion of women with the outcome is significantly different from baseline at the p<0.05 level based on the longitudinal generalized linear mixed model.
Dyspareunia was defined by a response of either “Always” or “Usually” PISQ-12 question B5 “Do you feel pain during intercourse” (for women who were sexually active), or a response of either “Always” or “Usually” to PISQ-12 question C4 “Does fear of pain during sexual intercourse restrict your activity” (for women who were not sexually active), or any postoperative treatment for dyspareunia. De novo dyspareunia was assessed in the subset of women who were sexually active without pain at baseline.
Due to the cumulative nature of treatment for dyspareunia, testing for differences between surgical groups is only performed on treatment by 24 months and time is not included in the model.
Values at 6-month, 12-month, and 24-month time points are adjusted mean changes from baseline and standard errors from the longitudinal general linear mixed models. Mean changes from baseline are significantly different from zero at the p<0.01 level.