Sexual function after urogynecologic surgery

PURPOSE OF REVIEW: The purpose of this review is to summarize and highlight contemporary studies evaluating sexual function after urogynecologic surgery. As nearly one in five women will undergo surgery for pelvic organ prolapse (POP) or urinary incontinence, it is critical to understand the impact of surgery on postoperative sexual function. This review includes a discussion of reconstructive surgeries for POP, uterine-preserving techniques, mesh-based prolapse repairs, and anti-incontinence procedures for both stress urinary incontinence (SUI) and urge urinary incontinence (UUI) and the associated effects on sexual function. RECENT FINDINGS: Women who undergo reconstructive POP surgery have many options for repair, including native tissue repair or mesh-based repairs, as well as uterine-sparing procedures or hysterectomy. Studies have shown general improvements in sexual functioning among all POP repair modalities, with no significant differences between modalities. Anti-incontinence procedures for SUI and UUI are also associated with improved sexual functioning. The majority of research in reconstructive pelvic surgery includes heterosexual, cisgender women. SUMMARY: Pelvic floor disorders are common and negatively affect sexual functioning. Surgical treatments for POP and urinary incontinence generally improve sexual functioning. Further research is needed given the ever-changing landscape of gynecologic surgery.