Assessment of quality of life and sexual function in women with symptomatic cystocele

Objective. To assess the quality of life and sexual function in women with symptomatic cystocele. Patients and methods. A prospective cross-sectional controlled study was conducted. It included 105 women: 70 patients with isolated symptomatic cystocele (N81.1) stage II-III according to the POP-Q classification and 35 women without signs of pelvic organ prolapse. All patients were matched for age and parity. The mean age of participants was 45.9 ± 8.0 years. Quality of life was assessed using validated questionnaires: PFDI-20 (Pelvic Floor Distress Inventory), P-QOL (Prolapse Quality of Life Questionnaire), PISQ-12 (Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire). Results. Patients with cystocele showed statistically significant pelvic floor dysfunction: total PFDI-20 score was 142.8 ± 52.4 vs. 18.6 ± 12.3 in the control group (p < 0.001, Cohen’s d = 2.86). The most severe disorders were noted in the domains of urinary symptoms (58.7 ± 24.1 vs. 6.2 ± 8.4, p < 0.001) and prolapse symptoms (52.7 ± 19.6 vs. 7.3 ± 6.8, p < 0.001). Cystocele had a systemic negative impact on all aspects of quality of life (P-QOL): the largest effect size was found in the “prolapse impact” domain (Cohen’s d = 4.35). The analysis of sexual function in women with cystocele demonstrated a significant negative impact on all aspects of sexual function (total PISQ-12 score 31.8 ± 6.2 vs. 37.4 ± 4.9, p < 0.001). Strong correlations were found between the anatomical degree of prolapse and specific perineological symptoms (r = 0.608–0.623). Multifactorial analysis showed that prolapse stage is the only independent predictor of deterioration in quality of life (β = 42.3, p < 0.001). Conclusion. Isolated symptomatic cystocele has a significant negative impact on women’s quality of life, affecting physical, psychological, social aspects of well-being, and sexual function. The anatomical degree of cystocele is the main predictor of functional disorder severity. © 2025 Elsevier B.V., All rights reserved.