Genugten, L. van (2012) De invloed van prolaps en prolapschirurgie op het seksueel functioneren bij de vrouw. thesis, Medicine.
Full text available on request.Abstract
Introduction: Pelvic organ prolapse (POP) has a prevalence that increases with age, to 41-75% above the age of 50, in women who gave birth vaginally. Symptomatic POP has a prevalence of 2,9-11%. Clinical manifestations may include urinary or defecatory symptoms and negative effects on sexual function. Sexual problems have been reported in over two-thirds of the patients, mainly concerning lubrication, dyspareunia and sexual satisfaction. Therefor sexual functioning is an important outcome measure of prolapse surgery. Studies on the impact of prolapse surgery on sexual function have shown conflicting results. Our hypothesis was that sexual functioning would worsen postoperatively, with regard to dyspareunia and lubrication. Aim: To evaluate sexual functioning in sexually active patients who are surgically treated for symptomatic POP. Secundary outcomes included micturation, defecation, quality of life and anatomical results. Methods: Sexual functioning was assessed in a prospective study, with patients being enrolled from the 1th of February untill the 31th of July 2012. Patients completed the Leiden Questionnaire, preoperatively and two months postoperatively. This questionnaire was also used to evaluate the secundary outcomes micturation and defecation. All patients completed the Rand-36 quality of life questionnaire. POP was graded using the Baden-Walker classificationsystem. SPSS 19.0 was used for statistical analysis. Pre- and postoperative scores were compared, using the Wilcoxon signed rank test. Significance was set at a p-value of < 0.05. Results: 74 patients were approached for this study, of which twenty-three patients (mean age 56.7 years) were included. Postoperatively we found a significant improvement with regard to orgasm during intercourse. For the remaining domains we didn’t find a significant difference. Looking at trends, sexual activity remained unchanged in 82.6% of patients and improved in 8.7%. Postoperatively dyspareunia improved in 47.8% of patients. Lubrication and satisfaction with the current sexual life showed improvement in respectively 34.8% and 40% of patients. The secondary outcomes quality of life, micturation and defecation didn’t change significantly. However, quality of life scores improved in 73.9%. We found a significant improvement in POP grading. Conclusion: Our results show that prolapse surgery is successful with regard to anatomical correction. Concerning sexual function, surgery appears to improve lubrication, dyspareunia, sexual satisfaction and orgasm during intercourse in a considerable part of patients and there was no negative influence on sexual activity. The alleged hypotheses has been rejected. Prolapse surgery doesn’t seem to change micturation and defecation and improves quality of life in the majority of patients.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Facultair begeleider: and Linden, dr. P.J.Q. van der |
| Supervisor name: | Plaatselijk begeleider: and Weis, drs. A.E. and Instelling: Deventer Ziekenhuis, Deventer and Lokatie: Afdeling Gynaecologie |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:56 |
| Last Modified: | 25 Jun 2020 10:56 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/1652 |
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