Bladder dysfunction after advanced pelvic surgeries: neuropelveological strategies for prevention and management.

Abstract

Advanced pelvic surgeries, such as radical hysterectomy, deep endometriosis surgery and sacrocolpopexy, pose risks to autonomic pelvic nerves leading to voiding dysfunction and reduced quality of life. This review article evaluates neuropelveological strategies for preventing and managing bladder dysfunction by exploring pelvic neural anatomy, nerve-sparing techniques, and postoperative rehabilitation approaches. Nerve-sparing approaches can reduce postoperative urinary retention and improve recovery of bladder function. Neuromodulation techniques provide additional support in managing persistent voiding dysfunction in selected cases. A multidisciplinary approach integrating detailed knowledge of pelvic neural anatomy, precise surgical techniques and structured postoperative management can minimise bladder dysfunction and optimise patient outcomes.