The Current Trends in Pelvic Surgery in Kharkiv

Objective: To analyse the structural and clinical shifts in surgical activities within a high-volume gynaecological department in Kharkiv, operating under frontline conditions during the full-scale war (2020–2025). Material and Methods: This is a retrospective clinical analysis of a database comprising 5,115 recorded operations. The study compares pre-war baseline activity (2020–2021) with wartime activities (2022–2025). Key variables included surgical access (minor, laparoscopic, vaginal, laparotomy), diagnostic profiles, patient age, and somatic comorbidities. Results: Total surgical volume nearly doubled during the conflict, increasing from 605 procedures in 2021 to a peak of 1,329 in 2023. Endometrial pathology and abnormal uterine bleeding remained the primary drivers of admission, accounting for 52.6% of cases. ‘Minor’ diagnostic procedures (D&C, polypectomy) proved essential as an oncological filter; analysis revealed that many verified endometrial adenocarcinomas (G1-G3) were postoperatively identified in cases initially presenting with benign findings like polyps or hyperplasia. Reconstructive vaginal surgery for pelvic organ prolapse (POP) saw a dramatic five-fold increase, rising from 20 cases in 2020 to consistently over 100 cases annually by 2023–2025. The patient demographic shifted significantly toward a geriatric population, with an average age peaking at 64.7 years in 2024 and successful interventions performed on patients up to 89 years of age. Conclusion: The Kharkiv Municipal Perinatal Centre successfully adapted to frontline pressures by transitioning into a specialised high-intensity centre. The facility prioritises minimally invasive reconstructive surgery and early oncology detection for an ageing, somatically burdened population, effectively evolving into a multidisciplinary surgical hub.