A Hidden Side Effect
Imagine recovering from surgery, only to notice something feels different in your body—something you can’t quite name. For many women, sexual changes after pelvic surgery are a quiet, unspoken concern.
A new study using detailed MRI scans has found a link between a common bladder surgery and changes in clitoral size and sexual function.
Pelvic organ prolapse and urinary incontinence affect millions of women, especially after childbirth or as they age. These conditions can be uncomfortable and embarrassing.
To fix these issues, surgeons often use a midurethral sling (MUS)—a small mesh strip that supports the bladder to prevent leaks. They also perform vaginal surgeries to repair a dropped uterus or vaginal wall.
But these procedures are close to the clitoris, a key organ for sexual pleasure. Until now, it wasn’t clear if surgery affected it.
The Surprising Shift
For years, the focus has been on whether surgery fixes the physical problem. But what about sexual function?
This study found that women who had a midurethral sling reported poorer sexual function after surgery compared to those who did not have the sling. They also had a smaller clitoris on MRI scans.
Here’s the twist: the type of vaginal surgery mattered too. Women who had a hysteropexy (uterus-sparing surgery) reported less improvement in sexual function than those who had a full hysterectomy.
How It Works: A Simple Analogy
Think of the clitoris like a small, sensitive switch. It’s located right next to the vagina and bladder area.
When a surgeon places a mesh sling or repairs the vaginal wall, they are working in a tight space. Even with careful technique, swelling, scar tissue, or changes in blood flow could affect the clitoris—like accidentally bumping a switch while fixing a nearby wire.
This study suggests that the sling itself, or the tension it creates, might put subtle pressure on the clitoris, potentially changing its size and function over time.
Researchers looked at 88 women who had vaginal surgery for pelvic organ prolapse between 2013 and 2015. About half had a midurethral sling added for incontinence.
They used MRI scans taken 30–42 months after surgery to measure clitoral size and position. They also surveyed women about their sexual function using a standard questionnaire.
First, the good news: overall, sexual function did not worsen for most women after surgery. Many reported staying the same or even improving.
But there was a clear difference between groups.
Women who had a midurethral sling had lower scores in arousal and orgasm compared to those without a sling. On MRI, their clitoral glans was thinner (9 mm vs. 10 mm) and their clitoral body volume was smaller (about 2,800 mm³ vs. 3,600 mm³).
Similarly, women who had hysteropexy had less improvement in sexual function than those who had a hysterectomy.
This doesn’t mean the sling is harmful for everyone.
Where Experts Stand
Researchers note that these findings are based on a specific group of women and should be interpreted with caution. The study shows a link, not a cause-and-effect.
They suggest that future studies should look more closely at how surgery changes clitoral anatomy and function over time.
If you’re considering pelvic surgery, talk to your doctor about potential sexual side effects. Ask about the type of sling used and whether there are alternatives.
This study does not mean you should avoid necessary surgery. It highlights the importance of discussing all possible outcomes with your surgeon.
This was a small, observational study. It only included women from eight U.S. clinics, and all had specific types of vaginal surgery. The results may not apply to everyone.
MRI measurements can vary, and sexual function is subjective. The study cannot prove that surgery caused the changes—only that they are associated.
More research is needed to understand how surgery affects the clitoris and sexual function. Future studies should include larger, more diverse groups and longer follow-up.
If confirmed, these findings could help surgeons refine techniques to better preserve sexual function. For now, open communication with your healthcare team remains key.
