Female sexual function after repair of uterovaginal prolapse.

OBJECTIVE: To evaluate the impact of repair of uterovaginal prolapse using sacrospinous hysteropexy on female sexual function. METHODS: A cross-sectional study was conducted at the Urogynecology Clinic of the Suez Canal University Hospital from May 2014 to April 2019. Twenty-seven women with a diagnosis of uterovaginal prolapse and wishing to preserve their uteri were recruited. Sacrospinous ligament fixation was done. Sexual symptoms were assessed using the female sexual function index (FSFI) questionnaire just before and 6 months after the operation. RESULTS: The mean age of the participants was 36.5 ± 4 years. Sacrospinous hysteropexy only was performed for three women. Additional procedures included anterior colporrhaphy (12), posterior colporrhaphy (9), and perineorrhaphy (15). There was a significant improvement in pre- and postoperative patients' orgasm (3.1 ± [0.8] vs. 3.7 ± [1.1]; p value = 0.03) and satisfaction (3.4 ± [0.6] vs. 4.2 ± [0.8]; p value < 0.001) while there was worsening of pain (4.3 ± [1.5] vs. 3.2 ± [1.6]; p value = 0.017). There was insignificant improvement in the other three domains as well as total score of FSFI, with all patients having sexual dysfunction. CONCLUSION: Sacrospinous hysteropexy was associated with significant improvement orgasm and satisfaction domains of FSFI and significant worsening of pain.

Late suture site complications of sacrospinous ligament fixation.

STUDY OBJECTIVE: To evaluate the late suture- related complications of sacrospinous ligament fixation (SSLF) as a treatment for uterovaginal prolapse and their impact on the quality of life. DESIGN: A prospective cohort study. SETTINGS: The Obstetrics and Gynecology Department of Suez Canal University Hospitals, Ismailia, Egypt from January 2014 to June 2018. PATIENTS: We recruited sixty women with uterovaginal prolapse. INTERVENTIONS: Patients underwent SSLF using the Capio suture recapturing device with non-absorbable suture material (0 braided Polyester). Postoperative visits were at six weeks then at 6, 12, 18, and 24 months after the procedure. MEASUREMENTS AND MAIN RESULTS: Outcome measures were the rate and timing of suture- related and the quality of life using the pelvic floor impact questionnaire-7 at 24 months postoperatively. The mean age of the studied population was 45.7 ± 9.8 years. Suture- related complications occurred in 55% (33/60) of patients, with vaginal discharge the most commonly reported symptom. Most of them presented in the 1st year after the procedure 72.7% (24/33), and 25% (15/60) had suture removal. However, there was a significant improvement in patients' quality of life. CONCLUSION: Sacrospinous ligament fixation has a positive impact on the quality of life, yet associated with significant but prominent suture- related complications.