Female sexual dysfunction after pelvic surgery: the impact of surgical modifications.

The National Health Survey (a large community-based study in women aged < 60 years) showed that 43% of 1749 women had some form of sexual dysfunction. FSD is certainly not a problem limited to young women; population census data from the USA show that ≈ 10 million American women aged 50–74 years self-reported some form of sexual dysfunction [1]. In a recently conducted international survey, which included 4507 women, 34% of the participants had decreased sexual interest and 19% did not consider sexual intercourse to be pleasurable [2]. FSD includes disorders of sexual desire, arousal and organic or sexual pain associated with self-distress. Sexual dysfunction after pelvic surgery is an important cause of organic dysfunction [3,4]. Pelvic surgery forms an important and underestimated cause of sexual dysfunction [3,4]. Urological surgery, e.g. simple and radical cystectomy (RC) and sling procedures, gynaecological surgery (simple and radical hysterectomy) and colorectal surgery (low anterior, or abdominoperineal, resection, APR) are among the most important causes of FSD. Recently, FSD has become a major quality-oflife issue in patients undergoing pelvic surgery.