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Can urogynaecologists improve the sexual health of women?

Can urogynaecologists improve the sexual health of women?

Pelvic organ prolapse
Significant Pelvic Organ Prolapse (POP) has been reported as a cause for sexually active women to cease vaginal coitus because of the difficulty in penetration or embarrassment or depression from alteration of body image. A ring pessary may be used to support less significant grades of POP and vaginal coitus is still possible. However, in significant Stage 3 or 4 POP, the ring pessary has a high chance of failure, requiring a Gelhorn pessary, which precludes vaginal coitus.

Fenton’s procedure
This is a very simple and effective procedure for women who suffer from superficial dyspareunia, recurrent urinary tract infection secondary to a high, tight and tender posterior commissure, usually after a previous overzealous episiotomy repair of posterior colpoperineorraphy.

Vaginal, subtotal or total abdominal hysterectomy

A prospective cohort of 413 women undergoing either of the three types of hysterectomy found significant improvements in sexual pleasure, 6 months after surgery in all groups.

Vaginal cosmetic surgery

To date, there is no good scientific evidence that such procedures improve the sexual function of women seeking them. Hence gynaecologists / urogynaecologists should counsel such women of the normal variation of the female genitalia, educate them of the female and male sexual response, inform them of the lack of evidence and counsel them of the complications of these procedures.

Conclusion: Gynaecologists or urogynaecologists can improve the sexual health of women.

Conference: WAS Singapore 2015