Risk Factors for readmission and repeated surgery in patients undergoing transperineal endoscopic pudendal nerve decompression: a cohort study

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Abstract

BACKGROUND: Transperineal endoscopic pudendal nerve decompression is an effective and minimally invasive treatment for patients with compressive pudendal neuropathy; however, some patients experience recurrence of symptoms, requiring repeat surgery.

AIM: To identify risk factors for readmission and repeated surgeries in patients after transperineal endoscopic pudendal nerve decompression.

METHODS: A single-center, retrospective cohort study was conducted (December 2023—October 2025). It included 524 patients (mean age 54.2 years, 48.5% males) who underwent endoscopic pudendal nerve decompression for compressive neuropathy. Within 90 days, 42 (8.0%) patients underwent repeated surgery, and 91 (17.0%) were readmitted for surgeryrelated reasons. We analyzed demographic, surgical, and comorbidity parameters (over 30 factors, including injury to the internal pudendal artery, valvular heart disease, and fluid and electrolyte imbalances). Univariate analysis was performed. Groups were compared using the t-test and Pearson chi-square test with Bonferroni correction.

RESULTS: The 90-day readmission rate was 17.0% (n = 91), and the repeated surgery rate was 8.0% (n = 42). No preoperative or intraoperative factor was significantly associated with repeated surgery (p > 0.05). Readmission was associated with injury to the internal pudendal artery (p < 0.001), valvular heart disease (p = 0.004), and fluid and electrolyte imbalances (p = 0.038). Postoperative complications included: pain exacerbations (8.2%), surgical site infections (1.5%), urinary tract infections (1.9%), and posthemorrhagic anemia (0.7%).

CONCLUSION: No risk factors for repeated surgery were identified. Readmissions were associated with injury to the internal pudendal artery, valvular heart disease, and fluid and electrolyte imbalances.

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About the authors

Vladimir A. Beloborodov

Irkutsk State Medical University

Email: BVA555@yandex.ru
ORCID iD: 0000-0002-3299-1924
SPIN-code: 5116-0931

MD, Dr. Sci. (Medicine), Professor, Head, Depart. of General Surgery

Russian Federation, Irkutsk

Ivan A. Stepanov

Irkutsk State Medical University; Kharlampiev Clinic

Author for correspondence.
Email: edmoilers@mail.ru
ORCID iD: 0000-0001-9039-9147
SPIN-code: 5485-6316

MD, Assistant Lecturer, Depart. of General Surgery

Russian Federation, Krasnogo Vosstaniya st, Irkutsk, 664003; Irkutsk

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