Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil; Department of Gynecology and Obstetrics, West Parana State University Medical School, Cascavel, Brazil.
Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil.
J Sex Med. 2019 Jan;16(1):126-136. doi: 10.1016/j.jsxm.2018.11.005.
Women's sense of attractiveness and body image, and the impact of pelvic organ prolapse (POP) over these constructs, are likely influenced by social and cultural background.
To evaluate sexual function and body image in women with POP, to compare the sense of attractiveness between women with and without POP, and to translate the Body Image in the Pelvic Organ Prolapse (BIPOP) questionnaire into Brazilian Portuguese and validate it in this population.
In this cross-sectional study of 105 Brazilian women with POP, we administered the BIPOP (scored from 1 to 5, with higher scores indicating worse body image), the Female Sexual Function Inventory (FSFI) (scored from 2 to 36, with higher scores indicating lower risk for sexual dysfunction), and the Attractiveness subscale of the Body Attitudes Scale questionnaire (BAQ) (scored from 5 to 35, with higher score indicating better body image). We also included 100 control women who completed the BAQ Attractiveness subscale questionnaire.
The main outcome measure included BIPOP, FSFI, and BAQ Attractiveness scores.
Mean BIPOP scores were 3.09 ± 1.08 in women with any POP, 3.05 ± 1.00 in those with lesser-stage POP (1 or 2), and 3.13 ± 1.15 in those with advanced-stage POP (3 or 4). There were no significant differences in score according to prolapse staging (P = .71). FSFI scores were independently associated with BIPOP scores (β = -0.052; P = .02). The mean scores for the BAQ Attractiveness subscale was 17.01 ± 4.07 in women with POP and 16.97 ± 4.60 in those without POP (P = .93). Older age was the sole characteristic associated with being sexually inactive in women with POP; regarding sexual function, a better body image and higher attractiveness scores were independently associated with a higher FSFI score. As for the Portuguese validation of the BIPOP instrument, the adapted version maintained good internal consistency (α = 0.908), good reliability (intraclass correlation coefficient, 0.94), and adequate construct validity.
Women with POP may not relate sexual function or attractiveness to POP extension. An impaired body image is associated with worse perception of attractiveness and increased risk for sexual dysfunction.
STRENGTH & LIMITATIONS: As strengths, we used a specific genital body image scale, and this is first study of its kind among Brazilian women. As for weaknesses, we encountered low educational levels in the women with POP.
Among women with POP, the anatomic features of the prolapse do not seem to interfere with genital body image or with sexual function. In addition, the presence of POP was not associated with being sexually active or inactive. Moroni RM, da Silva Lara LA, Ferreira CHJ, et al. Assessment of Body Image, Sexual Function, and Attractiveness in Women With Genital Prolapse: A Cross-Sectional Study With Validation of the Body Image in the Pelvic Organ Prolapse (BIPOP) Questionnaire. J Sex Med 2019;16:126-136.
女性的吸引力和身体形象，以及盆腔器官脱垂（POP）对这些结构的影响，可能受到社会和文化背景的影响。
评估患有 POP 的女性的性功能和身体形象，比较患有和不患有 POP 的女性之间的吸引力，将盆腔器官脱垂身体形象问卷（BIPOP）翻译成巴西葡萄牙语，并在该人群中进行验证。
在这项 105 名患有 POP 的巴西女性的横断面研究中，我们使用了 BIPOP（评分范围为 1 到 5，分数越高表示身体形象越差）、女性性功能指数（FSFI）（评分范围为 2 到 36，分数越高表示性功能障碍风险越低）和身体态度量表问卷的吸引力子量表（BAQ）（评分范围为 5 到 35，分数越高表示身体形象越好）。我们还纳入了 100 名完成 BAQ 吸引力子量表问卷的对照女性。
主要观察指标包括 BIPOP、FSFI 和 BAQ 吸引力得分。
任何 POP 女性的平均 BIPOP 评分为 3.09 ± 1.08，较轻阶段 POP（1 或 2）女性的平均 BIPOP 评分为 3.05 ± 1.00，较严重阶段 POP（3 或 4）女性的平均 BIPOP 评分为 3.13 ± 1.15。根据脱垂分期，评分无显著差异（P=0.71）。FSFI 评分与 BIPOP 评分独立相关（β=-0.052；P=0.02）。POP 女性的 BAQ 吸引力子量表平均得分为 17.01 ± 4.07，无 POP 女性的平均得分为 16.97 ± 4.60（P=0.93）。年龄较大是 POP 女性中唯一与性功能不活跃相关的特征；关于性功能，更好的身体形象和更高的吸引力评分与更高的 FSFI 评分独立相关。至于 BIPOP 仪器的葡萄牙语验证，改编后的版本保持了良好的内部一致性（α=0.908）、良好的可靠性（组内相关系数，0.94）和足够的结构有效性。
患有 POP 的女性可能不会将性功能或吸引力与 POP 扩展联系起来。受损的身体形象与对吸引力的感知较差和性功能障碍风险增加有关。
作为优势，我们使用了特定的生殖器身体形象量表，这是巴西女性中此类研究的首次。至于局限性，我们发现 POP 女性的教育水平较低。
在患有 POP 的女性中，脱垂的解剖特征似乎不会干扰生殖器身体形象或性功能。此外，POP 的存在与是否活跃无关。
