REVEALING DEFICIENCIES IN MANAGING FEMALE SEXUAL DYSFUNCTION IN WOMEN WITH PELVIC ORGAN PROLAPSE: A CALL FOR COMPREHENSIVE CARE

Female sexual dysfunction (FSD) is common in women with pelvic organ prolapse (POP), significantly impacting their sexual health and overall quality of life. Despite this, FSD is often inadequately managed in clinical settings, leading to suboptimal outcomes. Evidence-based guidelines recommend comprehensive management, including physical and psychosexual interventions, but adherence to these guidelines remains inconsistent. This study aims to evaluate current management practices for FSD in women undergoing POP treatment at a tertiary-level hospital.

A retrospective analysis was conducted on the medical records of 50 women who underwent pelvic floor repair surgeries for POP, including vaginal hysterectomy, anterior and posterior wall repair, sacrospinous fixation, and colpocleisis, at a tertiary-level hospital. The audit assessed the management strategies used to address sexual dysfunction, including pelvic floor rehabilitation, pharmacological interventions, and psychosexual therapy, as well as the documentation of discussions regarding sexual function changes pre- and post-surgery. Compliance with international guidelines for managing FSD in POP patients was evaluated.

The audit revealed significant gaps in the evaluation and management of FSD among POP patients. A sexual history was documented in only 53% of initial consultations. Pelvic floor rehabilitation was recommended in 40% of cases, and pharmacological interventions were discussed with 29% of patients. Psychosexual therapy was not suggested in any cases, and follow-up on sexual function post-surgery occurred in only 14% of cases. Additionally, only 8% of patients were informed about potential changes in sexual function pre-surgery, and changes in sexual function were documented in just 8% of post-surgery assessments. These findings indicate a lack of comprehensive management strategies that integrate both physical and psychological aspects of care.

There is a critical need for a more integrated approach to managing FSD in women with POP, incorporating both physical and psychosexual interventions. The audit highlights the necessity of enhancing clinician education and access to psychosexual services to improve the quality of care and outcomes for these patients. Developing standardised management protocols and adopting a biopsychosocial model are essential steps to ensure holistic care for women affected by both POP and FSD.

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