Urethral prolapse affects women of any age, but cystocele appears in more advanced ages. Both disorders have a negative impact in the sexual sphere of our patients.  
The aim of this study is to identify the factor affecting sexual sphere in patients with urethral prolapse and/or cystocele.

Retrospective observational study of 17 women with complicated urethral prolapse (thrombosis or bleeding) between 2000 and 2020, classified in two groups: GF: Feeling vaginal bulge GNF: Not. 
Variables: Age at surgery, body mass index (BMI), concomitant disorders and drug treatment, toxic habits, medical and surgical background, gynaeco-obstetric history; health status defined by the American Society of Anaesthesiologists (ASA) Physical Status Classification System, reason for consultation, time between diagnosis and surgery, size and pathological results of the resected tissue, functional results: SF-36 quality of life questionnaire, urinary incontinence, bleeding, dyspareunia, urinary urgency and/or frequency.
Descriptive statistics, hypothesis contrast and multivariant analysis (logistic regression).

Mean age was 70.41 years. Mean BMI was 23.67, greater in GF (p= 0.027). Mean follow-up time was 231.58 days, without differences between groups. A higher frequency of depression and dyslipidaemia, as well as a higher ASA score, were found in patients in GF. 
Urethral bleeding was the most common reason of consultation. No relationship between ECOG score, concomitant disorders or treatments, toxic habits, Pathology results or surgical technique’s variables. Urinary incontinence was present before surgery in 10 patients, and only in one after it. Sexual sphere was affected in 50% of patients in GF and in 10% of patients in GNF. 
Multivariate analysis: Patients with preoperative urinary incontinence have three-times more probability of having cystocele (p=0.025). The greater the BMI, patients have 1.863-times more probability of presenting cystocele (p=0.027). The lesser affectation of the sexual sphere, patients have 0.200 less probability of presenting cystocele (p=0.023). Correlation between sexual sphere’s affectation and the number of deliveries, with a positive regression coefficient (1.700), shows a positive or direct tendency: the greater the number of deliveries, the greater the sexual sphere’s affectation (p=0.008).

Pelvic organ prolapse has a negative impact in patients’ quality of life, including the sexual sphere. According to literature, our results show that pelvic organ prolapse can induce multiple functional problems like urinary incontinence and urinary tract infections, but it can also affect the sexual and psychological spheres of our patients. 
In our series, it was shown that patients with a greater BMI and preoperative urinary incontinence have more probabilities to have cystocele and a greater affectation of their sexual life. Having had more deliveries was also associated with a negative effect in sexual sphere.

The affectation of the sexual sphere due to urethral prolapse is directly associated with concomitant cystocele and urinary incontinence before surgical correction of urethral prolapse.