Sexual activity among Nigerian women following successful obstetric fistula repair

• Published in: International journal of gynecology and obstetrics Vol. 137; no. 1; pp. 67 - 71
• Main Authors: Anzaku, Stephen A., Lengmang, Sunday J., Mikah, Samaila, Shephard, Steven N., Edem, Bassey E.
• Format: Journal Article
• Language: English
• Published: United States 01-04-2017
• Subjects: Adult; Coitus; Cross-Sectional Studies; Delivery, Obstetric - adverse effects; Female; Humans; Male; Nigeria; Obstetric fistula; Postoperative Period; Quality of Life; Rectovaginal Fistula - surgery; Sexual dysfunction; Sexual Dysfunction, Physiological - etiology; Sexual Dysfunction, Physiological - psychology; Sexual Dysfunctions, Psychological - etiology; Sexual Dysfunctions, Psychological - psychology; Sexual life; Surveys and Questionnaires; Vesicovaginal Fistula - surgery; Young Adult; Sexual life; Nigeria; Obstetric fistula; Sexual dysfunction
• ISSN: 0020-7292; 1879-3479
• DOI: 10.1002/ijgo.12083

Objective
To evaluate post‐operative sexual activity among women who have undergone obstetric fistula repair.
Methods
The present descriptive cross‐sectional study recruited married women who had undergone successful obstetric fistula repair who were attending reunion activities at Bingham University Teaching Hospital, Jos, Nigeria, between March 13 and March 15, 2014. Participants were interviewed regarding penetrative vaginal intercourse after surgery, and any changes in sexual desire, arousal, orgasm, sexual satisfaction, and the presence of coital pain compared with before they experienced obstetric fistula.
Results
There were 102 patients who participated in interviews; 23 (22.5%) reported not being able to engage in penetrative vaginal intercourse and 12 (52%) of these patients ascribed this to a “tight” or “narrow” vagina. Compared with the pre‐fistula period, 63 (61.7%) patients reported reduced sexual desire, 57 (55.9%) reported lack of or inadequate lubrication during intercourse, 12 (11.8%) reported anorgasmia, and 60 (58.8%) reported reduced attainment of orgasm. Dyspareunia was reported by 48 (47.1%) patients; 43 (90%) experienced superficial or deep dyspareunia, and 5 (10%) experienced both. A lack of and lower sexual satisfaction were reported by 20 (19.6%) and 40 (39.2%) patients, respectively.
Conclusion
Following obstetric fistula repair, many women experienced difficulty engaging in penetrative vaginal intercourse and reported sexual dysfunction. Management of sexual dysfunction should be part of fistula rehabilitation programs.
Following obstetric fistula repair, a majority of patients experienced some form of sexual dysfunction and approximately one‐fifth were unable to engage in penetrative vaginal intercourse.