Sexual Function 6 Months After First Delivery

Brubaker, Linda MD¹; Handa, Victoria L. MD²; Bradley, Catherine S. MD³; Connolly, AnnaMarie MD⁴; Moalli, Pamela PhD, MD⁵; Brown, Morton B. PhD⁶; Weber, Anne MD⁷ for the Pelvic Floor Disorders Network

Author Information

From the¹Departments of Obstetrics/Gynecology and Urology, Loyola University Medical Center, Maywood, Illinois;²Department of Obstetrics and Gynecology, Johns Hopkins University, Baltimore, Maryland;³Department of Obstetrics and Gynecology, University of Iowa, Iowa City, Iowa;⁴Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina;⁵Department of Obstetrics and Gynecology, University of Pittsburgh, Pittsburgh, Pennsylvania;⁶Department of Biostatistics, University of Michigan, Ann Arbor, Michigan; and⁷National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland.

See related editorial on page 1037.

*For members of the Pelvic Floor Disorders Network, see the Appendix online atwww.greenjournal.org/cgi/content/full/111/5/1040/DC1.

Supported by grants from the National Institute of Child Health and Human Development (U01 HD41249, U10 HD41268, U10 HD41248, U10 HD41250, U10 HD41261, U10 HD41263, U10 HD41269, and U10 HD41267).

Corresponding author: Linda Brubaker, MD, Loyola University Chicago, 2160 South First Avenue, Maywood, IL 60153; e-mail:[email protected].

Financial Disclosure The authors have no potential conflicts of interest to disclose.

Obstetrics & Gynecology111(5):p 1040-1044, May 2008. |DOI:10.1097/AOG.0b013e318169cdee

OBJECTIVE:

To explore the association of anal sphincter laceration and sexual function 6 months postpartum in the Childbirth and Pelvic Symptoms (CAPS) cohort.

METHODS:

The primary CAPS study, a prospective cohort study, was designed to estimate the postpartum prevalence and incidence of urinary and fecal incontinence. Three cohorts of new mothers (vaginal delivery with a third- or fourth-degree anal sphincter tear, vaginal delivery without a third- or fourth-degree anal sphincter tear, and cesarean delivery without labor) were compared at 6 months postpartum. Sexual function was assessed with the Pelvic Organ Prolapse/Urinary Incontinence/Sexual Function Short Form Questionnaire (PISQ-12). Urinary and fecal incontinence were assessed using the Medical Epidemiological and Social Aspects of Aging questionnaire and the Fecal Incontinence Severity Index, which is embedded within the Modified Manchester Health Questionnaire.

RESULTS:

Most women (459 [90%]) of those with partners reported sexual activity at the 6-month visit. Fewer women whose delivery was complicated by anal sphincter laceration reported sexual activity when compared with those who delivered vaginally without sphincter laceration (88 compared with 94%,P=.028). The mean PISQ-12 score (39±4) did not differ between delivery groups (P=.92). Pain (responses of “sometimes,” “usually,” or “always”) during sex affected one of three sexually active women (164 [36%]).