New pelvic symptoms are common after reconstructive pelvic surgery

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 ≤ .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.