Pelvic organ prolapse (POP) occurs in approximately 50 % of parous women. Pelvic organ prolapse (POP) can have a negative impact on sexual function. Surgery for POP corrects the pathologic process, but it might also alter sexual function. Our study aim is to compare the sexual function following transvaginal mesh (TVM) repair and laparoscopic long mesh surgery (LLMS) for the treatment of POP .

This was a retrospective study with Fifty-six consecutive women with symptomatic POP stages II to IV defined by the POP quantification (POP-Q) staging system were referred for TVM or LLMS procedures at our hospitals. All subjects were divided into the TVM group (n=30) and LLMS group (n=26). Preoperative and postoperative assessments included pelvic examination using the POP-Q system, multi-channel  urodynamic study, one hour pas test and a personal interview to evaluate urinary and sexual symptoms with the short forms of Urogenital Distress Inventory (UDI-6) and Incontinence Impact Questionnaire (IIQ-7), and the Female Sexual Function Index (FSFI).Laparoscopic Long Mesh Surgery(LLMS) is a novel surgical approach designed for the treatment of apical prolapse. with augmented round ligaments was designed to create ventral uterine suspension by anchoring the mesh to the cervix and round ligaments. It has shorter operating time (about 1hr) , less time to master, less post-operative complications compared to laparoscopic sacrocolpopexy (current gold standard treatment of apical prolapse)

There was no difference between the 2 groups as for age, parity, diabetes, hypertension, concomitant procedures (P>0.05). Regarding the POP-Q analysis, there was a significant improvement at points Aa, Ba, C, and Bp (P<0.05) in both groups except for point Ap and total vaginal length (P>0.05). After LLMS surgery, the total scores and orgasm domain improved significantly (P<0.05). However, other domains did not show significant difference in both groups.

Different types of TVM implantation may cause different effect on sexual function.Total TVM appeared to cause greater sexual impairment compared with anterior TVM alone. New generation of TVM cause less dyspareunia and mesh erosion with smaller in size, less dense texture and a single incision Design, only anterior compartment but not total vaginal wall. Laparoscopic sacrocolpopexy had a positive impact on sexual function. Laparoscopic long mesh suspension experienced greater sexual improvement on total scores and orgasm following surgery compared to vaginal mesh repair due to less vaginal mesh erosion and less condom like effect.

Both TVM and laparoscopic mesh procedures create an effective anatomical restoration of POP. Compared with the TVM group, women undergoing laparoscopic mesh suspension experienced a greater sexual improvement on total scores and orgasm following surgery.