Quinlan Monica, Olagundoye Victor
Urogynecology Department, Birmingham City Hospital, Birmingham, United Kingdom.
AJOG Glob Rep. 2025 Mar 27;5(2):100485. doi: 10.1016/j.xagr.2025.100485. eCollection 2025 May.
Pelvic organ prolapse is a common condition with high prevalence among postmenopausal women, many of whom are sexually active. A vaginal pessary is an effective, nonsurgical treatment alternative for well-selected, motivated patients and those unfit for surgical management. Open discussion on sexual function is a crucial part of counseling in these women to ensure that they are fitted with the most appropriate pessary and minimize complications.
This study aimed to explore healthcare professionals' experiences of discussing sexual function with postmenopausal women with pelvic organ prolapse receiving vaginal pessary management in a urogynecology clinic.
Semistructured, in-depth qualitative interviews were conducted in a tertiary university teaching hospital in England with an established urogynecology department. The sample comprised 10 volunteers (7 female and 3 male, consisting of 3 consultants, 1 advanced nurse practitioner, 2 clinical nurse specialists, and 4 specialist registrars). All volunteers were experienced in managing women with prolapse, including inserting and removing vaginal pessaries and discussing sexual intercourse and intimacy.
Postmenopausal women were found to be reluctant and embarrassed to engage in open discussion on sexual intimacy, which can be improved by building trust. Being seen by female healthcare professionals, having a female chaperone, and using appropriate interpreters (in cases of language barriers) significantly improved women's willingness to discuss sexual issues.
The study demonstrated that postmenopausal women found it difficult and were hesitant and embarrassed to openly discuss sexual issues, which is important in choosing the most suitable vaginal pessary. This problem can be alleviated by building trust between healthcare professionals and patients, by healthcare professionals remaining sensitive to patients' ethnic and cultural backgrounds, and by respecting women's choice of healthcare professional.
盆腔器官脱垂是绝经后女性中一种常见且患病率较高的疾病，其中许多人仍有性生活。阴道子宫托是一种有效的非手术治疗方法，适用于精心挑选、有积极性的患者以及那些不适合手术治疗的患者。对于这些女性，关于性功能的公开讨论是咨询过程中的关键部分，以确保她们佩戴最合适的子宫托并将并发症降至最低。
本研究旨在探讨医疗保健专业人员在泌尿妇科诊所与接受阴道子宫托治疗的绝经后盆腔器官脱垂女性讨论性功能的经验。
在英国一所设有泌尿妇科的三级大学教学医院进行了半结构化的深入定性访谈。样本包括10名志愿者（7名女性和3名男性，其中有3名顾问医生、1名高级执业护士、2名临床护士专家和4名专科住院医生）。所有志愿者在管理脱垂女性方面都有经验，包括插入和取出阴道子宫托以及讨论性交和亲密关系。
发现绝经后女性在公开讨论性亲密关系时不情愿且感到尴尬，通过建立信任可以改善这种情况。由女性医疗保健专业人员诊治、有女性陪护人员以及在存在语言障碍时使用合适的口译员，可显著提高女性讨论性问题的意愿。
该研究表明，绝经后女性发现公开讨论性问题困难、犹豫且尴尬，而这在选择最合适的阴道子宫托时很重要。通过在医疗保健专业人员与患者之间建立信任、医疗保健专业人员对患者的种族和文化背景保持敏感以及尊重女性对医疗保健专业人员的选择，这个问题可以得到缓解。
