الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
The vagina is a sexual organ, and like in men, the sexual arousal function of the woman requires adequate vascular and neurological supply. Sexual arousal results in congestion and vaginal wall thickening, tenting, and lubrication as well as production of mucous secretion and opening of the vaginal orifice.
Benign gynecological conditions that affect women‘s reproductive organs include endometriosis, uterine fibroids, pelvic masses, and uterine cysts. Surgical Interventions is an option for complicated cases. However, the impact of surgical intervention on women‘s sexual life has been widely overlooked.
Female sexual dysfunction (FSD) is a multifactorial problem and involves physical, social, and psychological dimensions. FSD includes disorders of sexual desire, arousal, orgasm and pain. Various causes could affect sexual function in women, such as age, etnichity, education, history of sexual abuse or sexually transmited disease, emotional or stress-related problems, health status, multiparity or menopause.
Clearly, all vaginal functions might be disturbed as a result of vaginal surgery, but remarkably few studies have addressed these issues and results from studies differ. A prospective Swedish study showed a small improvement of sexual desire and dyspareunia but impaired orgasmic function after surgery for stress urinary incontinence.
The aim of the study was to evaluate the female sexual functions in women whom done vaginal surgery.
SUMMARY
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Two hundred married female patients, having stable marital state in the last 6 months and active sexual life and underwent vaginal surgeries, were included in the study.
The following data were fulfilled from different gynecology and obstetrics clinics in Menoufia University hospitals:
1. Detailed history taking: including age, education, residence, occupation, number of children and associated comorbidity.
2. Surgical history, including: circumcesion and the vaginal surgery.
3. The Arabic version of FSFI questionnaire (Ar-FSFI) was used, consisting of six domains. Four domains are related to the four major categories of sexual function: desire, arousal, orgasm and sexual pain disorder. The fifth domain assesses the quality of vaginal lubrication, and the sixth domain is related to global sexual and relationship satisfaction.
Results of this study showed that:
● The mean age was 35.82 years. Of the studied females, 60.5% were secondary and intermediate education, 16.5% university education, 10.5% read & write and preparatory education and 2% illiterate.
● 74% of the cases were urban residence, 66% had children from 1 to 3, 4% more than 4 children, 77.5% were not circumcised and 36.5% have associated comorbidities including HTN, DM and cardiovascular diseases.
● As regard the type of vaginal surgeries, 34% of the females had history of episiotomy, 19% rectovaginal fistula, 17% Bartholin abscess, 15.5% vaginal hysterectomy, 6.5% vaginoplasty, 5% surgical removal of warts and 3% vaginal tumor removal.
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● As regard the desire domain of FSFI score, there was statistically significant relation between desire domain and the following; age, having children, associated comorbidities and vaginal surgery type. Higher desire score was detected among younger age groups 20 and more & 30 and more years), having higher number of children (≥4) and females with no comorbidities.
● The highest desire scores were found among females with Bartholin abscess & episiotomy.
● As regard the arousal domain, there was statistically significant relation between arousal domain and the following; age and associated comorbidities. The lowest arousal score was detected among females aged ≥40 years and among cases with positive comorbidities.
● As regard the lubrication domain, there was statistically significant higher lubrication score among not working females, no associated comorbidities and episiotomy surgery, surgical removal of vaginal warts, Bartholin abscess and recto-vaginal fistula.
● As regard the orgasm domain, there was statistically significant higher mean orgasm score among the following; younger age groups (20- & 30- years), not working females and presence of associated comorbidities. The lowest orgasm score was detected among females with vaginal tumor removal and surgical removal of vaginal warts.
● There was a statistically significant relation between satisfaction domain of female sexual function index score and age, occupation, residence, children number, associated comorbidities and different types of vaginal surgeries.
SUMMARY
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● Higher satisfaction score was detected among older age groups (30, 40 &50 years and more), not working females, having children ≥ 4 children, non-circumcised females, no associated comorbidities and with Episiotomy and Vg hysterectomy.
● Lowest satisfaction score was detected among females with Vg tumor removal, surgical removal vg warts & vaginoplasty.
● There was a statistically significant lower pain score among females with comorbidities and among females with rectovaginal fistula and females with episiotomy.
● While higher pain score was detected among females with no comorbidities and among females with Vg hysterectomy, Vg tumor removal and vaginoplasty.
● There was a statistically significant total FSFI score among females with comorbidities and among females with vaginal tumour removal, recto-vaginal fistula, episiotomy with the highest score detected among females with vaginoplasty.
● However, no a statistically significant relation was found between total FSFI score and age, educational level, occupation, residence and number of children (P>0.05).
● Among cases with good FSFI; 93.5% had no associated comorbidities and 33.3% had episiotomy, 20.4% Bartholin abscess, & 18.3% rectovaginal fistula.