[De novo pelvic dysfunctions after vaginal urogynecological surgeries]

Abstract

The goal of vaginal reconstructive surgery is to address pelvic issues. Surgical procedures can greatly enhance the lives of many women by alleviating symptoms and improving their overall well-being. However, there are instances where women experience pelvic dysfunction for the first time - new or worsening symptoms in the pelvic area that emerge following surgery. The purpose of the review is to summarize current knowledge, identify existing gaps and suggest future research directions aimed at minimizing iatrogenic morbidity and improving the quality of life of patients. A search was conducted using PubMed, Scopus, Web of Science, and Cochrane Library databases. The search queries included various combinations of the following keywords: "pelvic floor dysfunction", "urogynecology", "vaginal surgery", "pelvic organ prolapse", "stress urinary incontinence", "overactive bladder", "de novo", "postoperative complications", "urination dysfunction", "dyspareunia", "fecal incontinence", "quality of life", "synthetic mesh", "repair with native tissues" and "results of surgical intervention". The search was limited to English-language publications from January 1, 2014 to December 31, 2024 (including articles published in early 2025). Literature data convincingly indicate that a significant proportion of women who have undergone urogynecological vaginal surgery develop de novo pelvic dysfunctions. The etiology of de novo pelvic dysfunction is complex and multifactorial, including nerve injury, mesh-related complications, altered pelvic floor biomechanics, pre-existing subclinical dysfunction, and psychological factors. Identifying risk factors and implementing strategies to prevent and effectively treat new dysfunction are critical to optimizing surgical outcomes and patient well-being.

Keywords: de novo; dyspareunia; fecal incontinence; overactive bladder; pelvic floor dysfunction; pelvic organ prolapse; postoperative complications; quality of life; repair with native tissues; results of surgical intervention; stress urinary incontinence; synthetic mesh; urination dysfunction; urogynecology; vaginal surgery.