ABSTRACT

Background: Pelvic organ prolapse (POP) significantly impacts women's quality of life, with

symptoms including pelvic pain and dyspareunia. This study aims to evaluate the improvement

of pelvic pain, including low backache, pelvic pain, and dyspareunia, following pelvic floor

reconstructive surgery.

Methods: A prospective cohort study was conducted at the Aga Khan Hospital Karachi,

enrolling 35 women with POP. Patients were followed from February 2022 to January 2023,

assessing outcomes through validated questionnaires (POPDI-6, FSFI) preoperatively and at 1, 3,

and 6 months postoperatively. The study focused on the impact of surgery on pelvic pain and

dyspareunia, with an analysis of potential factors influencing pre-operative pain severity.

Results: The mean POPDI-6 scores significantly decreased from 59.05±45.15 pre-operatively to

7.14±15.54 at 6 months postoperatively, indicating a significant improvement in pelvic pain

(p<0.001). Dyspareunia prevalence reduced from 60.0% pre-operatively to 14.3% six months

after surgery. Diabetic patients were more likely to experience severe pre-operative pain

(p=0.007). However, contrasting evidence from Ulrich et al. suggests that specific surgical

techniques, like levator plication, may increase postoperative dyspareunia rates.

Conclusion: Pelvic floor reconstructive surgery effectively improves pelvic pain and reduces

dyspareunia in women with POP. The study highlights the need for personalized treatment

approaches, considering individual patient characteristics and comorbidities, such as diabetes,

which may influence pain severity and surgical outcomes.