Surgery to correct urinary incontinence or pelvic organ prolapse can have a significant effect on women below the age of 50. In the first study of its kind, 40% of sexually dysfunctional women became sexually active after surgery and 20% reported increased sexual satisfaction. Among women who were sexually active before surgery, nearly all were sexually functional after the procedure and 20% reported an increase in sexual satisfaction.
   "Female sexual dysfunction is a growing field but a poorly understood field," said Mitchell Bamberger, MD, chief of urology at St. Vincent Hospital and associate professor of surgery at the University of Massachusetts Medical School in Worcester.
   "We used to treat women with incontinence in their 60s or 70s, now we're treating younger women in their 30s who don't want to live with pads and diapers," he told the American College of Surgeons Clinical Congress. "Nobody has ever looked at how pelvic floor reconstruction surgery may or may not improve female sexual function."
    Dr. Bamberger's research team mailed questionnaires to 38 premenopausal women following pelvic floor surgery and received 21 responses. Questionnaires were mailed between four and 31 months after surgery with a mean followup period of 14.8 months. Procedures used vaginal slings and similar less intrusive surgical techniques.
   The biggest surprise, he said, was the self-reported finding that nearly a quarter of women in the study were sexually dysfunctional due to incontinence or vaginal prolapse despite their relatively young age. Although the study size was small, the results encouraged the team to plan a larger prospective trial to compare sexual functioning before and after pelvic support surgeries.
   "Overall, our results suggest that restoring continence is associated with better sexual functioning in young women," he said. "Surgical correction of pelvic floor disorders is very strongly associated with increased sexual functioning."