New pelvic symptoms are common after reconstructive pelvic surgery.

Abstract

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