Impact of Vaginal Hysterectomy on Quality of Life, Body Image, and Sexual Function in Women with Pelvic Organ Prolapse: A Study of Rural Women in a Low-Resource Setting.

Abstract

Introduction and hypothesis: This study examines the repercussions of vaginal hysterectomy and apical suspension for prolapse, when used as a surgical remedy for pelvic organ prolapse (POP), with regard to sexual function, body image, and the overarching quality of life (QoL) in women living in low- to middle-income rural areas.

Methods: We conducted a longitudinal assessment involving 108 sexually active women with a diagnosis of stage 3 or higher POP undergoing vaginal hysterectomy and apical suspension for prolapse. Evaluations were performed preoperatively and at 6 months postoperatively. Participants underwent qualitative in-depth interviews and completed the 36-item Short Form Health Survey (SF-36), Body Image Scale (BIS), and Female Sexual Function Index (FSFI). We calculated aggregate and domain-specific scores from these instruments and utilized the Wilcoxon signed-rank test to discern pre- to post-surgical changes.

Results: Data from a total of 108 women were analyzed. The mean age of participants was 56.65 ± 10.03 years. Post-hysterectomy outcomes showed a statistically significant enhancement in sexual function, evidenced by increased scores on the FSFI from 13.42 ± 4.87 preoperatively to 27.99 ± 4.88 postoperatively (p < 0.001). Notable improvements were similarly recorded on the BIS and SF-36 subscales (p < 0.001). Qualitative analyses suggested that these positive changes in sexual function might be directly attributable to the alleviation of POP-related symptoms.

Conclusions: Pelvic floor dysfunction presents a multifaceted health concern with both functional and anatomical repercussions for affected individuals. This investigation highlights the association between pelvic reconstructive procedures and improvement in women's QoL in an understudied population.