Sexual Function Following Surgical Approaches for Pelvic Organ Prolapse

Study Objective: Pelvic organ prolapse (POP) can negatively affect body image and sexual function in women. The objective of this review is to describe changes to sexual function, dyspareunia, and other sexual function domains after POP surgery. Design: This narrative review will describe prior systematic review results on this topic with a search through January 2025 on how POP surgery affects other domains of sexual function, such as sexual desire, arousal, satisfaction, lubrication, and orgasm. Results: Both the systematic review and more recent trials show an improvement or similar scores in overall sexual function after POP surgery. These improvements in sexual function persisted when measured 5 years postoperatively. A total of 50% to 74% of women have resolution of dyspareunia after surgery, and de novo dyspareunia ranges from 0% to 9% with the exception of posterior repairs. De novo dyspareunia after posterior repair is approximately 14%, based on limited data. Sexual desire, arousal, and satisfaction usually improve after POP surgery, whereas the effect on orgasm and lubrication is limited or conflicting. Conclusion: Sexual function either improves or remains unchanged after surgical repairs for prolapse. Dyspareunia rates decrease after all types of POP surgery, whereas the risk of de novo dyspareunia remains low. Domains of sexual desire, arousal, and satisfaction also tend to improve after prolapse repair.