Standardized Counseling Tool for Returning to Sexual Activity after Pelvic Reconstructive Surgery

OBJECTIVE:To create a standardized counseling tool for return to sexual activity after pelvic reconstructive surgery.METHODS:An expert panel created an initial counseling tool based on the conceptual framework previously developed in a rigorous qualitative analysis of women's experience of their first sexual encounters after pelvic reconstructive surgery. This instrument was then refined through cognitive patient interviews. Women who had previously undergone reconstructive surgery for pelvic organ prolapse or urinary incontinence and returned to sexual activity were recruited from four clinical sites across the United States and Canada for participation in cognitive interviews. Participants reviewed proposed counseling statements and were asked to describe their meaning, suggest any necessary changes, and rate their importance. Summaries of the ongoing cognitive interviews were periodically presented to the working group for discussion, and the instrument was revised accordingly. Interviews were conducted until no new substantive comments were made.RESULTS:Nineteen cognitive patient interviews were conducted, and three rounds of modifications were made to the initial counseling tool. Modifications included merging multiple counseling statements to avoid redundancy and eliminating statements that were not considered important by patients. Patients consistently rated statements about the safety of resuming intercourse and anticipated discomfort with initial sexual encounters as very important.CONCLUSION:We developed a novel, patient-centered counseling tool for the return to sexual activity after pelvic reconstructive surgery using a previously established conceptual framework and cognitive patient interviews. It addresses an important surgical outcome for patients and offers surgeons a concise, high-value counseling tool.