Pham Thythy, Kenton Kimberly, Mueller Elizabeth, Brubaker Linda
Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology and Urology, Loyola University Medical Center, Maywood, IL, USA.
Am J Obstet Gynecol. 2009 Jan;200(1):88.e1-5. doi: 10.1016/j.ajog.2008.08.010. Epub 2008 Oct 9.
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.
