How Does Pelvic Organ Prolapse Repair Affect Sexual Function?

By Amit Saxena
September 5, 2025

Pelvic organ prolapse repair is a crucial procedure for many experiencing discomfort. It aims to correct the descent of pelvic organs, which can impact daily life and sexual function.
Understanding how this surgery affects sexual health is vital for patients. Many report improvements post-surgery, but it’s essential to discuss potential changes with a healthcare provider.
Exploring treatment options and recovery tips can empower patients. With the right support and information, individuals can navigate their journey to better pelvic health.

Summary

This article published in American Journal of Obstetrics and Gynecology September 2025 reports on a multicenter, randomized trial evaluating how body image and sexual function change after surgical repair for posthysterectomy vaginal vault prolapse. Three surgical approaches were compared: transvaginal native tissue repair, abdominal mesh sacrocolpopexy, and transvaginal mesh. A total of 335 women participated, with a mean age of 66 years and the majority presenting with stage 3 prolapse.

Key Findings

Significant improvement in body image was observed as early as 6 months after surgery, and this improvement was sustained through 36 months across all surgical groups.
There were no statistically significant differences in body image improvement between surgical approaches, whether mesh was used or not, or by the route (vaginal vs abdominal).
Individual aspects of body image—such as concerns about intimacy, attractiveness, and confidence—improved significantly postoperatively and this effect lasted over three years.
About 44% of participants were sexually active at baseline. Among sexually active women, sexual function also improved after surgery in all groups, with no significant differences between procedures.
Improvements in body image and sexual function were strongly correlated at all time points, even after adjusting for baseline differences, age, surgical type, and dyspareunia.
Women who experienced surgical failure (persistent or recurrent prolapse needing retreatment) showed poorer postoperative body image

Clinical Implications

Surgical repair for vaginal vault prolapse—regardless of approach—consistently improves both body image and sexual function over three years.
Sexually active patients considering prolapse surgery can expect both psychological and sexual health benefits, regardless of procedure type.
Mesh augmentation did not adversely affect body image or sexual function in this cohort.

Research & Clinical Relevance

These findings provide important reassurance for women considering prolapse repair and help resolve controversies regarding the impact of different surgical techniques on wellbeing.
Surgical choice may be guided by clinical factors, with confidence in comparable quality-of-life outcomes for body image and sexual function.