Predictors of de novo pelvic dysfunction after reconstructive pelvic surgery with vaginal access: a prospective cohort study

Ausheva B.Kh., Kasyan G.R., Pushkar D.Yu.

1) Russian University of Medicine of the Ministry of Health of the Russian Federation, Moscow, Russia; 2) Botkin’s Hospital Moscow Urological Center, Moscow, Russia

Introduction. Vaginal reconstructive surgery aims to correct pelvic dysfunctions, but some patients may experience new symptoms after the procedure. These patients may develop a negative attitude toward treatment. The available literature is ambiguous due to the use of different study samples, instruments, and insufficient follow-up periods for this patient group.
Objective. The aim of the prospective cohort study was to identify predictors of de novo pelvic dysfunction after vaginal reconstructive surgery while monitoring patients for 12 months.
Materials and methods. A prospective cohort study included 159 patients admitted for surgery for pelvic dysfunction. Prior to surgery, patients completed validated questionnaires – PISQ-12, ICIQ-SF, PFIQ-7, PFDI-20. After the surgical treatment, patients were invited for follow-up visit after 3, 6, and 12 months, during which they were asked to complete questionnaires again and undergo a gynecological exam.
Results. The prevalence of de novo pelvic dysfunction in women after vaginal urogynecological surgery was 9,7%, according to our study. In three quoistionares (ICIQ-SF, PFDI-20, and PFIQ-7), a higher ICIQ-SF score significantly increases the risk of postoperative urinary incontinence. Higher BMI also increases of postoperative urinary incontinence. The PFDI-20 preoperative questionnaire scores predict a chance of pelvic organ prolapse.
Conclusions. Modern research shows that despite the success of urogynecological operations, such as correction of pelvic prolapses and incontinence treatment, the risk of de novo pelvic dysfunction remains significant. Improving the treatment and monitoring of patients with pelvic dysfunctions creates favorable conditions for reducing the number of postoperative complications and de novo symptoms.

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About the Authors

Corresponding author: Bella Kh. Ausheva – M.D.; Urologist, Obstetrician-gynecologist, Postgrad. Student Dept. of Urology, Russian University of Medicine, Moscow, Russian Federation; e-amil: bellausheva@mail.ru

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