Quality of life and sexual changes after double transobturator tension-free approach to treat severe cystocele

Objectives: To study the quality of life and sexual function changes of women affected by severe cystoceleand treated with the double transobturator tension-free approach.Study design: 23 women (mean age 60.6) with third and fourth degree cystocele (according to Baden andWalker classification) were monitored by Short Form-36 (SF-36) and Pelvic Organ Prolapse/UrinaryIncontinenece Sexual Questionnaire (PISQ-12) before and 12 months after surgical treatment.Each woman also underwent translabial color Doppler ultrasonography to measure the ResistanceIndex (RI), Pulsatility Index (PI), Peak Systolic Velocity (PSV), and End-Diastolic Velocity (EDV) of theclitoral arteries, before surgery and 12 months postoperatively.Results: SF-36 showed a considerable increase in all of the categories (physical functioning, physical rolefunctioning, bodily pain, general health, vitality, social functioning, emotional role functioning, andmental health) compared to those obtained at baseline (P < 0.05).PISQ-12 also showed a considerable increase in the behavioural emotive factor score, in the physicalfactor score, in the partner-related factor score and, consequently, in the total score compared to thatobtained at baseline (P < 0.05).Color Doppler measurement showed that the mean Pulsatility Index, Peak Systolic Velocity,Resistance Index and End-Diastolic Velocity were not significantly lower to those obtained at baseline(P = NS).Conclusions: Double transobturator tension-free approach to treat severe cystocele considerablyimproves quality of life and sexual function, and does not significantly influence clitoral blood flow. Ourdata could add new information about sexual behaviour after prolapse treatment, particularly about theimpact on clitoral blood flow changes.