Sexual function in women with obstetric anal sphincter injuries in the postpartum period. Analysis according to the mode of delivery
Anglès, SAA1; Ros, CRC1; Elías, NES1; Palau, MJP1; Espuña, MEP1
1: Pelvic Floor Unit, Spain
Objective: To evaluate sexual function in women with and without history of obstetric anal sphincter injuries (OASIS), according to the mode of delivery.
Material and Methods: A total of 320 women were included in a prospective study: 140 with history of primary repaired OASIS and 180 women without OASIS as the control group. All patients filled out the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) at 6 months postpartum (score 0-48, the more the better). Questions number 5 (pain), 6 (urinary incontinence during intercourses) and 12 (quality of orgasm) were analyzed individually. Sexual function of women was compared according to the mode of delivery.
Results: Results of PISQ-12 of women with and without history of OASIS were similar (8.1±3.6 OASIS vs 7.5±1.8 no-OASIS;NS), as the percentage of women sexually active (PWSA) at 6 months postpartum was (73%OASIS vs 69% no-OASIS). Considering patients with normal deliveries (with and without OASIS), no differences were found considering the PISQ-12 (8±1.9 both), but the PWSA was significantly higher among women without OASIS: 44/60 (73%) and 43/44 (98%). Surprisingly, when patients with instrumental deliveries (ID) were compared, the PWSA was significantly higher among women with OASIS (59/80, 73%) vs no-OASIS (82/136, 60%). Results of PISQ-12 were non significantly higher in the OASIS group (8.1±4.5 OASIS and 7.3±41.8 no-OASIS; NS). When all participants were compared according to the mode of delivery (normal vs ID), clear differences were found in PISQ-12 total score (6.6±3.4 normal vs 5±4.5 ID;p<0.001). ID scored worse in question 5, 6 and 12 than women with normal deliveries.
Conclusions: In general, women with OASIS obtain similar results in PISQ-12 than women without OASIS at 6 months postpartum. After normal deliveries, women with OASIS begin sexual activity later, but with similar results in the sexual questionnaire. However, only 60% of women with ID without OASIS are sexually active at 6 months postpartum, whereas 75% with OASIS and normal delivery are. Women with ID have worse sexual function than women with normal deliveries, independently of the history of OASIS.
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