Effect of vaginal polypropylene mesh implants on sexual function

Objective: Published studies report a very high rate of dyspareunia and impairment of sexual function in women who have undergone vaginal mesh repair. The present study investigates these problems with a view to sex therapy. Study design: A validated questionnaire was administered to 120 women to explore sex life before and after polypropylene mesh insertion (Apogee(R)/ Perigee(R)). Postoperative exploration took place 1 year after surgery. In addition, gynecologic examinations were performed preoperatively and postoperatively to assess urogenital anatomy and function. Results: Fifteen women reported dyspareunia before surgery, which was related to vaginal prolapse. No woman complained of dyspareunia at 1-year follow-up. In 40 patients (33.3%), analysis of the validated questionnaires revealed more deeply rooted sexual disorders based on partnership problems and unrelated to surgery. Conclusion: The results presented here show that vaginal mesh repair does not interfere with a healthy sex life. Our data on sexual function and activities suggests that sexuality is complex and cannot be reduced to mere genital aspects. Sexual dysfunction is only rarely associated with urogynecologic surgery. (C) 2008 Elsevier Ireland Ltd. All rights reserved.