Do alterations in vaginal dimensions after reconstructive pelvic surgeries affect the risk for dyspareunia?

Objective The purpose of this study was to determine whether changes in vaginal dimensions after transvaginal reconstructive pelvic surgeries affect the risk for postoperative dyspareunia. Study design Charts of all sexually active patients who underwent transvaginal reconstructive pelvic surgeries in our institution between July 1998 and June 2002 with 1 year of follow-up evaluations were reviewed. Data were analyzed with the Student t, χ2, Pearsonʹs correlation tests and a logistic regression model. Results Two hundred twenty-eight women aged 44 to 83 years were included. Dyspareunia increased after operation (16% vs 7%; P = .001); total vaginal length (7.6 vs 8.8 cm; P = .001) and genital hiatus (2.7 vs 3.5 cm; P = .001) dimensions significantly decreased after operation, with no predilection for any specific procedure. No correlation was found between these changes in vaginal dimensions and the risk for dyspareunia. Conclusion The prevalence of dyspareunia increases after transvaginal reconstructive pelvic surgeries. Despite a postoperative decrease in vaginal dimensions, a causal relationship between dyspareunia and changes in vaginal dimensions may not exist.