New pelvic symptoms are common after reconstructive pelvic surgery

Am J Obstet Gynecol. 2009 Jan;200(1):88.e1-5. doi: 10.1016/j.ajog.2008.08.010. Epub 2008 Oct 9.

Abstract

Objective: The objective of the study was to determine the incidence of new pelvic symptoms after reconstructive pelvic surgery and its impact on surgical outcomes.

Study design: Women undergoing surgery for prolapse (POP) and/or urinary incontinence underwent preoperative and 3 month postoperative assessment: urodynamics, pelvic organ prolapse quantification, and Pelvic Floor Distress Inventory (PFDI-20). Postoperative assessment included Patient Global Impression of Improvement (PGI-I), satisfaction, and new symptom questionnaire.

Results: Forty-two percent (33/79) reported new pelvic symptoms: incontinence (27%), urgency (25%), frequency (23%), difficult defecation (22%), voiding difficulty (10%), and POP (2%). Women with new symptoms differed from those without: higher postoperative mean PFDI-20 scores (P < .001 for Urinary Distress Inventory, P = .02 for Pelvic Organ Prolapse Distress Inventory, and P = .02 Colorectal-Anal Inventory); 58% vs 83% improved on PGI-I, compared with 83% (P = .01); 33% vs 83% completely satisfied (P <or= .001).

Conclusion: Women report high rates of new pelvic symptoms after surgery, which are associated with decreased self-reported improvement and satisfaction despite improvement on validated quality of life measures.

MeSH terms

  • Cohort Studies
  • Female
  • Humans
  • Middle Aged
  • Patient Satisfaction
  • Pelvic Floor / surgery*
  • Plastic Surgery Procedures*
  • Prospective Studies
  • Statistics, Nonparametric
  • Surveys and Questionnaires
  • Treatment Outcome
  • Urinary Incontinence / surgery*
  • Urodynamics / physiology
  • Uterine Prolapse / surgery*