(231) Evaluation of Sexual Satisfaction Following Surgery for Pelvic Organ Prolapse at the Korle-Bu, Accra

Introduction Pelvic organ prolapse(POP) is the anatomical prolapse with descent of at least one of the vaginal walls to or beyond the vaginal hymen with maximal valsalva effort with the presence either of bothersome characteristic symptoms, most commonly the sensation of vaginal bulge, or of functional or medical compromise due to prolapse without symptom bother. This descent may occur in one or more structures. POP may be associated with urinary incontinence, voiding dysfunction, incomplete defecation, and sexual dysfunction. Prevalence of POP in Ghana ranges from 2.68% to 12.07%. One of the major concerns of clients with pelvic organ prolapse is the inability to have sex as a result of the sensation of a mass in the vagina. Objective The main objective of the study was to evaluate sexual satisfaction following surgery for pelvic organ prolapse at the Korle-Bu Teaching Hospital (KBTH), Accra. The study sought to determine the anatomic outcomes post-surgery for POP, the level of sexual satisfaction post-surgery for POP, the correlation between the vaginal length, genital hiatus and sexual satisfaction and to compare sexual satisfaction before and post-surgical repair for POP at the KBTH, Accra. Methods This was a longitudinal study that evaluated the sexual satisfaction following surgery for POP at the KBTH, Accra. 48 participants were evaluated for their sexual satisfaction using the PISQ IR prior to surgery for POP after obtaining consent. Disposable calibrated tapes were used to measure the Total Vaginal Length (TVL), Genital Hiatus (GH) and the POP-Q stage post-surgical repair. A repeat test was done about 3 months after surgery when the participants had resumed sexual function. The study lasted for a year from August 2023 to July, 2024. Results Of the participants enrolled, 69% were available for the post-surgical evaluation. There was a statistically significant improvement in sexual satisfaction following surgery for pelvic organ prolapse at the KBTH. Pre operative 50th percentile PISQ IR score was 50.5 with a mean of 53.9 (+/- 15.5) whiles the 50th percentile value for the post operative scores was 77.5 with a mean of 76.9 (+/- 12.04), p<0.001. There was improvement in all the domains of the female sexual response cycle as well as dyspareunia. Desire, arousal and orgasm improved from preoperative 50th percentiles of 2(IQR 1.5, 3), 2 (IQR 2, 3), 2(IQR 1, 2) to post operative values of 4(IQR 3, 4), 4(IQR 3, 4), 4(IQR 3, 4) respectively with p < 0.001. Dyspareunia significantly improved from 3(IQR 2.5, 4) to 4(IQR 3, 4), P = 0.017. There was a moderate spearman correlation of 0.41 between TVL and sexual satisfaction, p=0.014 but no correlation was found between GH and sexual satisfaction. Conclusions Surgery for pelvic organ prolapse significantly improved post-operative sexual satisfaction with improvements in the domains of desire, arousal, orgasm and dyspareunia. There was a moderate spearman correlation between vaginal length and sexual satisfaction but no correlation between Genital Hiatus and sexual satisfaction. Disclosure No