(Poster 52) Pelvic Organ Prolapse Burden on Female Body Image and Sexuality: A Cohort Study

Objectives: Pelvic organ prolapse (POP) is common in female patients and affects sexuality and body image. Limited data exist in non-sexually active (NSA) females with POP. Describe the burden of POP on sexuality and body image of patients seeking surgery; explore associations between sexual activity and body image.

Methods: Secondary analysis of a patient cohort at baseline of an RCT of two POP reconstructive surgeries at five Canadian tertiary centres. Validated questionnaires (POP/Urinary Incontinence Sexual Questionnaire-IUGA-revised, and Body Image in Pelvic Organ Prolapse (BIPOP) Questionnaire were completed, along with demographic data. Descriptive statistics and appropriate tests of significance were used.

Results: Of 175 patients, 84 (48%) were sexually active (SA), of mean (SD) age 62.2 (11.1). SA patients were younger, with fewer comorbidities. Patients were NSA from pelvic symptoms (67.5%), lack of interest (52.7%), lack of partner (41.3%). NSA patients were fearful (77.4%), frustrated (59%), sexually inferior (56.1%), profoundly dissatisfied (50.7%), and angry (45.7%), because of pelvic symptoms interfering with sexuality. Similarly, one half of SA patients felt frustrated, inferior, embarrassed and angry; 75.3% avoided sexual activity. NSA patients felt a lot more fearful, more dissatisfied and inadequate when compared with SA patients (p < 0.05 and adjusted analyses). 165 patients completed BIPOP (80% partnered), with similar scores between SA and NSA patients. Partnered NSA patients were more likely than SA to avoid sexual intimacy because of POP, OR 2.32 (95%CI 1.15, 4.68).

Conclusions: The burden of POP-related sexual dysfunction is high in both SA and NSA patients awaiting POP surgery, with differences in specific aspects of pelvic-organ-specific body image.