Pelvic organ prolapse burden on sexual health and body image: a cross-sectional study
Bibliographic record
Abstract
Abstract Background Pelvic organ prolapse (POP) is common and can affect sexual health and body image. Sexual concerns of non-sexually active (NSA) females with POP have been poorly described. Aim To describe the burden of POP and explore associations between sexual function and body image in all patients seeking surgery. Methods Secondary analysis of a baseline patient cohort, randomized controlled trial (RCT) of 2 POP reconstructive surgeries at 5 urogynecology tertiary centers. We present baseline sexual activity, function, and sex-related affect and body image. Patients scheduled for POP surgery completed validated condition-specific questionnaires of sexual function, body image, demographics, POP burden, and medical comorbidities. We used descriptive statistics and appropriate tests of significance. Outcomes Differences between sexually active (SA) and NSA patients in POP-specific sexual function and body image; associations between body image and impaired sexual function. Results Of 181 patients, 86 (47.5%) were SA, with a mean (SD) of age 62 (11.1). SA patients were younger, with fewer comorbidities. 30/86 (35%) had clinically significant sexual function impairment. Reasons for being NSA included pelvic symptoms (69.1%), lack of interest (53.8%), and lack of partner (40.5%). Frustration, sexual inferiority, and anger were similar between NSA and SA patients. NSA patients have 5 times the odds of avoiding sexual activity because of fear of pelvic symptoms; twice the odds of being more dissatisfied and twice the odds of feeling more inadequate in their sex life than SA patients. (P < .05, unadjusted and adjusted analyses). A total of 171 patients (80% partnered) had similar body image scores between SA and NSA patients. Partnered NSA patients were more likely than SA to avoid sexual intimacy because of POP, aOR 2.35 (95% CI, 1.03-5.33). Patients who had clinically significant POP-related impairment of sexual function had significantly worse body image (P < .001). Clinical Implications Patients with clinically bothersome POP have significant sexual concerns. Body image was similarly affected regardless of sexual activity. Perceived partner avoidance of intimacy was a common barrier. This is an opportunity for tailored sexual health individual and couples counseling. Strengths and Limitations Our findings apply to many surgical POP patients regardless of partner or sexual activity status. Limitations include missing data, no validated measure of sexual distress, and no evaluation of partner sexual function. Conclusion The burden of POP-related sexual dysfunction and corresponding poor body image is substantial in both SA and NSA patients awaiting POP surgery. In the preoperative assessment of POP, sexual health and body image questions should be routinely included.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".