Sexual disorders in women who have undergone surgery for pelvic organ prolapse or stress urinary incontinence using synthetic prostheses

Nechiporenko N.A., But-Gusaim L.S., Nechiporenko A.N.

1) Grodno State Medical University, Grodno, Republic of Belarus; 2) Grodno City Clinical Hospital of Emergency Care, Grodno, Republic of Belarus
The paper provides a literature review on sexual dysfunctions that have developed in women after vaginal colpopexy with Prolift, Prosima, and Elevate synthetic mesh prostheses that correct pelvic organ prolapse, as well as stress urinary incontinence using TVT and TVT-obturator synthetic mesh tapes. It is noted that there is the highest incidence of postoperative complications with the development of female sexual functions (dyspareunia, pelvic pain) after surgery using synthetic mesh prostheses implanted by the trocar-guided technology according to the Prolift principle. Non-trocar-guided technologies for the installation of mesh prostheses that correct pelvic organ prolapse, the Prosima and Elevate systems are characterized by a significantly lower frequency of postoperative complications and, accordingly, a lower incidence of dyspareunia and other sexual disorders in women. The analysis of the results of surgical treatment for pelvic organ prolapse in women shows that the best anatomical and functional outcomes are achieved with Prosima Elevate synthetic mesh prostheses using non-trocar-guided technologies, by reducing the trauma rate of operations. Sexual dysfunctions after surgical restoration of continence in women with TVT and TVT-obturator mesh tapes can develop when a suburethral tape is placed under the distal urethra, by damaging the clitoral nerve.
Conclusion. The impact of urogynecologic surgeries using synthetic mesh prostheses on female sexuality requires further investigations.


pelvic organ prolapse
stress urinary incontinence
surgical treatment
synthetic mesh prostheses
sexual disorders


  1. Rogers R.G., Kammerer-Doak D., Darrow A., Murray K., Qualls C., Olsen A., Barber M. Does sexual function change after surgery for stress urinary incontinence and/or pelvic organ prolapse? A multicenter prospective study. Am. J. Obstet. Gynecol. 2006; 195(5): e1-4.
  2. Ghielmetti T., Kuhn P., Dreher E.F., Kuhn A. Gynaecological operations: do they improve sexual life? Eur. J. Obstet. Gynecol. Reprod. Biol. 2006; 129(2): 104-10.
  3. Baszak-Radomanska E., Paszkowski T. Zaburzenia seksualne u kobiet po operacjach uroginekologicznych z zastosowaniem biomaterialow. In: Rechberger T., ed. Uroginekologia praktyczna. Lublin; 2007: 93-5.
  4. Achtari C., Dwyer P.L. Sexual function and pelvic floor disorders. Best Pract. Res. Clin. Obstet. Gynaecol. 2005; 19(6): 993-1008; quiz A1-8.
  5. Lermann J., Häberle L., Merk S., Henglein K., Beckmann M.W., Mueller A., Mehlhorn G. Comparison of prevalence of hypoactive sexual desire disorder (HSDD) in women after five different hysterectomy procedures. Eur. J. Obstet. Gynecol. Reprod. Biol. 2013; 167(2): 210-4.
  6. Lin T.Y., Su T.H., Huang W.C. Polypropylene mesh used for adjuvant reconstructive surgical treatment of advanced pelvic organ prolapse. J. Obstet. Gynaecol. Res. 2010; 36(5): 1059-63.
  7. Handa V.L., Cundiff G., Chang H.H., Helzlsouer K.J. Female sexual function and pelvic floor disorders. Obstet. Gynecol. 2008; 111(5): 1045-52.
  8. Zielinski R., Miller J., Low L.K., Sampselle C., DeLancey J.O. The relationship between pelvic organ prolapse, genital body image, and sexual health. Neurourol. Urodyn. 2012; 31(7): 1145-8.
  9. Рыжков С.В., Остапенко А.В., Шабунина Е.Ю., Никонова А.С., Михайлов А.Г., Полонская Е.И., Пампуло Н.С. Оценка сексуальной функции у женщин после оперативного лечения пролапса гениталий и/или недержания мочи при напряжении. Современные проблемы науки и образования. 2011; 6: 26. [Ryizhkov S.V., Ostapenko A.V., Shabunina E.Yu., Nikonova A.S., Mihaylov A.G., Polonskaya E.I., Pampulo N.S. Evaluation of sexual function in women after operative treatment of prolapse of genitalia and/or urinary incontinence when stressed. Current problems of science and education. 2011; 6. (in Russian)].
  10. Сеняева Н.Н., Аполихина И.А. Сексуальные дисфункции у женщин с урогинекологическими заболеваниями. Акушерство и гинекология. 2011; 5: 20-8. [Senyaeva N.N., Apolikhina I.A. Diagnosis of sexual dysfunction in women with urogynecological diseases. Obsterics and Gynecology. 2011; 5: 20-8. (in Russian)].
  11. Чебакова Ю.В., Тетерина Т.А., Иванова Е.С., Сарыглар С.И., Стеняева Н.Н., Аполихина И.А. Психологические особенности сексуальной функции женщин с нарушениями мочеиспускания. Акушерство и гинекология. 2014; 3: 61-8. [Chebakova Yu.V., Teterina T.A., Ivanova E.S., Saryglar S.I., Stenyaeva N.N., Apolikhina I.A. Psychological characteristics of sexual function in women with urination disorders. Obsterics and Gynecology. 2014; 3: 61-8. (in Russian)].
  12. Bermann J., Bermann L., Kanaly K.A. Female sexual dysfunction: new perspective on anatomy, physiology, evaluation and treatment. EAU Update Series. 2003; 1: 166-77.
  13. Yeni E., Unal D., Verit A., Kafali H., Ciftci H., Gulum M. The effect of tension-free vaginal tape (TVT) procedure on sexual function in women with stress urinary incontinence. Int. Urogynecol. J. Pelvic Floor Dysfunct. 2003; 14(6): 390-4.
  14. Tunuguntla H.S., Gousse A.E. Female sexual dysfunction following vaginal surgery: a review. J. Urol. 2006; 175(2): 439-46.
  15. Connell K., Guess M.K., Lacombe J., Wang A., Lazarou G., Mikhail M. Evaluation of the role of pudendal nerve integrity in female sexual function using non-invasive techniques. Am. J. Obstet. Gynecol. 2005; 192(5): 1712-7.
  16. Shah S.M., Bukkapatnam R., Rodríguez L.V. Impact of vaginal surgery for stress urinary incontinence on female sexual function: is the use of polypropylene mesh detrimental? Urology. 2005; 65(2): 270-4.
  17. Navara G., Galfano A., Mancini M. Critical assessment of pelvic floor surgical reconstruction outcome. EAU Update Series. 2006; 4: 202-13.
  18. Roos E.J., de Graeff A., van Eijkeren M.A., Boon T.A., Heintz A.P. Quality of life after pelvic exenteration. Gynecol. Oncol. 2004; 93(3): 610-4.
  19. Salvatore S., Soligo M., Meschia M., Luppino G., Piffarotti P., Arcari V. Prosthetic surgery for genital prolapse: functional outcome. Neurourol. Urodyn. 2002; 21(4): 296-7.
  20. Baessler K., Schuessler B. Abdominal sacrocolpopexy and anatomy and function of the posterior compartment. Obstet. Gynecol. 2001; 97(5, Pt 1): 678-84.
  21. Беженарь В.Ф., Гусева Е.С., Цыпурдеева А.А., Русина Е.И., Цуладзе Л.К. Сравнительная оценка осложнений и качества сексуальной жизни после коррекции генитального пролапса различными синтетическими имплантатами. Российский вестник акушера-гинеколога. 2014; 14(2): 57-62. [Bezhenar V.F., Guseva E.S., Tsyipurdeeva A.A., Rusina E.I., Tsuladze L.K. Comparative assessment of complications and quality of sexual life after genital prolapse correction by various synthetic implants. Russian bulletin of an obstetrician-gynecologist. 2014; 14(2); 57-62. (in Russian)].
  22. Jha S., Moran P., Greenham H., Ford C. Sexual function following surgery for urodynamic stress incontinence. Int. Urogynecol. J. Pelvic Floor Dysfunct. 2007; 18(8): 845-50.
  23. Milani R., Salvatore S., Soligo M., Pifarotti P., Meschia M., Cortese M. Functional and anatomical outcome of anterior and posterior vaginal prolapse repair with prolene mesh. BJOG. 2005; 112(1): 107-11.
  24. Huser M., Pastorčáková M., Belkov I., Sedláková K. Outcomes of anterior vaginal wall repair using polypropylene mesh. Ceska Gynekol. 2012; 77(5): 407-13.
  25. Беженарь В.Ф., Гусева Е.С., Цыпурдеева А.А., Русина Е.И., Цуладзе Л.К. Сравнительная оценка качества жизни больных после коррекции генитального пролапса различными синтетическими имплантатами. Журнал акушерства и женских болезней. 2013; 62(5): 15-28. [Bezhenar V.F., Guseva E.S., Tsypurdeyeva AA. et al. Comparative assessment of life quality of patients after the correction of genital prolapse with different synthetic implants. Journal of obstetrics and women's diseases. 2013; 62(5): 15-28. (in Russian)]. doi: 10.17816/JOWD62515-28. (in Russian)].
  26. Гвоздев М.Ю., Тупикина Н.В., Пушкарь Д.Ю., Касян Г.Р. Первый опыт применения в России бестроакарных сетчатых технологий в лечении больных с тазовым пролапсом. Российский вестник акушера-гинеколога. 2012; 12(5): 57-63. [Gvozdev M.Yu., Tupikina N.V., Pushkar' D.Yu., Kasian G.R. Russia's first experience with trocar-free mesh technologies in the treatment of patients with pelvic prolapse. Russian bulletin of obstetrician-gynecologist. 2012; 12(5): 57-63. (in Russian)].
  27. Sayer T., Lim J., Gauld J.M., Hinoul P., Jones P., Franco N., Van Drie D., Slack M.; Prosima Study Investigators. Medium-term clinical outcomes following surgical repair for vaginal prolapse with tension-free mesh and vaginal support device. Int. Urogynecol. J. 2012; 23(4): 487-93.
  28. Baginska J.E. Prosima – a new device for pelvic organ prolapse repair. An initial experience. Eur. Urol. 2011; 10(9, Suppl.): 622.
  29. Chen J., Zhu L., Lang J.H., Shi H.H., Lou W.J., Sun Z.J., Gong X.M. Prospective study on total pelvic reconstruction surgery with Prosima in the treatment of pelvic organ prolapse stage III. Zhonghua Fu Chan Ke Za Zhi. 2012;47(9): 664-8.
  30. Шкарупа Д.Д., Кубин Н.Д. Протезирующая реконструкция тазового дна влагалищным доступом: современный взгляд на проблему. Экспериментальная и клиническая урология. 2015; 1: 88-93. [Shkarupa D.D., Kubin N.D. Prosthetic reconstruction of the pelvic floor using vaginal approach: contemporary view. Experimental and Clinical Urology. 2015; 1: 88-93. (in Russian)].
  31. Камоева С.В. Новые технологии использования сетчатых имплантатов в реконструктивной хирургии тазового дна при пролапсе тазовых органов у женщин. Российский вестник акушера-гинеколога. 2012; 12(1): 64-9. [Kamoeva S.V. New technologies for using mesh implants in pelvic floor reconstructive surgery in women with pelvic organ prolapse. Russian bulletin of obstetrician-gynecologist. 2012; 12(1): 64-9. (in Russian)].
  32. Huang K.H., Huang L.Y., Chu L.C., Chuang F.C., Wu M.P., Kung F.T. Evaluation of the single-incision Elevate system to treat pelvic organ prolapse: follow-up from 15 to 45 months. Int. Urogynecol. J. 2015; 26(9): 1341-6.
  33. Макаров О.В., Камоева С.В., Голубева Д.В. Трансвагинальная система Элевейт (Elevate) в реконструктивной хирургии тазового дна после гистерэктомии. Медицинский альманах. 2011; 6: 142-4. [Makarov O.V., Kamoeva S.V., Golubeva D.V. Transvaginal system elevate in reconstructive surgery of pelvic floor after hysterectomy. Medical Almanac. 2011; 6(19):142-4. (in Russian)].
  34. Diwadkar G.B., Barber M.D., Feiner B., Maher C., Jelovsek J.E. Complication and reoperation rates after apical vaginal prolapse surgical repair: a systematic review. Obstet. Gynecol. 2009; 113(2, Pt 1): 367-73.
  35. Lowman J.K., Jones L.A., Woodman P.J., Hale D.S. Does the prolift system cause dyspareunia? Am. J. Obstet. Gynecol. 2008; 199(6): 707. e1-6.
  36. O'Connell H.E., Hutson J.M., Anderson C.R., Plenter R.J. Anatomical relationship between urethra and clitoris. J. Urol. 1998; 159(6): 1892-7.
  37. Porter W.E., Steele A., Walsh P., Kohli N., Karram M.M. The anatomic and functional outcomes of defect-specific rectocele repairs. Am. J. Obstet. Gynecol. 1999; 181(6): 1353-8.
  38. Zyczynski H.М., Slack M., Reisenauer C., Khandwala S., Van Drie D., Franco N. et al. A new operation for vaginal prolapse repair using mesh and a vaginal support device: 1 year anatomic and functional results of an international multicenter study. J. Urol. 2009; 181(4):483.
  39. Высоцкий М.М., Дигаева М.А., Орленко Е.И. «Элевейт» – трансвагинальная система, используемая в реконструктивной хирургии тазового дна у пациенток с генитальным пролапсом. Акушерство и гинекология Санкт-Петербурга. 2017; 2: 76-9. [Vysotsky M.M., Digaeva M.A., Orlenko E.I. "ELEVATE" – transvaginal system used in reconstructive surgery of the pelvic floor in patients with genital prolapse. Obstetrics and Gynaecology of St. Petersburg. 2017; 2: 76-9. (in Russian)].
  40. Gauruder-Burmester A., Koutouzidou P., Rohne J., Gronewold M., Tunn R. Follow-up after polypropylene mesh repair of anterior and posterior compartments with recurrent prolapse. Int. Urogynecol. J. Pelvic Floor Dysfunct. 2007; 18(9): 1059-64.
  41. Nguyen J.N., Burchette R.J. Outcome after anterior vaginal prolapse repair: a randomized controlled trial. Obstet. Gynecol. 2008; 111(4): 891-8.
  42. Lemack G.E., Zimmern P.E. Sexual function after vaginal surgery for stress incontinence: results of a mailed questionnaire. Urology. 2000; 56(2): 223-7.
  43. Maaita M., Bhaumik J., Davies A.E. Sexual function after using tension-free vaginal tape for the surgical treatment of genuine stress incontinence. BJU Int. 2002; 90(6): 540-3.
  44. Helström L., Nilsson B. Impact of vaginal surgery on sexuality and quality of life in women with urinary incontinence or genital descensus. Acta Obstet. Gynecol. Scand. 2005; 84(1): 79-84.
  45. United States Food and Drug Administration. Available at:
  46. Bartuzi A., Futyma K., Kulik-Rechberger B., Skorupski P., Rechberger T. Transvaginal Prolift® mesh surgery due to advanced pelvic organ prolapse does not impair female sexual function: a prospective study. Eur. J. Obstet. Gynecol. Reprod. Biol. 2012; 165(2): 295-8.

Received 20.11.2020

Accepted 16.04.2021

About the Authors

Nikolaj A. Nechiporenko, Dr. Med. Sci., professor, professor of the Department of Surgical Diseases II, Grodno State Medical University.
Tel.: +375296331273. Е-mail: ORCID: 0000-0002-1544-9287. 230009, Republic of Belarus, Grodno, Gorkij str., 80.
Liudmila S. But-Husaim, Cand. Med. Sci., Vice-Director of Grodno City Clinical Hospital of Emergency Care.
Tel.: +375291117003. E-mail: ORCID: 0000-0001-9503-0963. 230027, Republic of Belarus, Grodno, Sov. Pogranichnikov str., 115.
Alexander N. Nechiporenko, Dr. Med. Sci., professor of the Department of Surgical Diseases II, Grodno State Medical University.
Tel.: +375296513569. Е-mail: ORCID: 0000-0002-3304-6393. 230009, Republic of Belarus, Grodno, Gorkij str., 80.

For citation: Nechiporenko N.A., But-Gusaim L.S., Nechiporenko A.N. Sexual disorders in women who have undergone surgery for pelvic organ prolapse or stress urinary incontinence using synthetic prostheses.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2021; 5: 33-39 (in Russian)

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