Pelvic Organ Prolapse

CONCLUSIONS: EP‑RSH may represent a feasible and safe expert‑level alternative to RSC in carefully selected patients. When performed by experienced robotic surgeons, EP‑RSH achieved comparable short‑term outcomes while avoiding peritoneal entry and Trendelenburg positioning. Further multicenter validation and structured training are warranted.

CONCLUSIONS: A two-port totally laparoscopic colonopexy provided effective stabilization of the colon and successful resolution of recurrent rectal prolapse in this cat. This approach may represent a valuable minimally invasive alternative in selected feline patients, particularly those with behavioural limitations that restrict postoperative handling and medical management.

BackgroundPhysiotherapy treatment for women with pelvic organ prolapse (POP) requires a holistic approach based on tensegrity theory and fascial connections.ObjectiveThe study examined the tension of transverse body structures (transverse diaphragms) in healthy women and women with pelvic organ prolapse. To draw attention to the fact that treating women with pelvic organ prolapse requires a holistic approach and not just pelvic floor muscle exercises.DesignA cross-sectional studies.MethodsThe...

Genital prolapse is very rare in neonates. In neonates affected by spina bifida, genital prolapse can occur due to improper nerve supply to the pelvic diaphragm. When genital prolapse occurs in neonates, it can be associated with severe morbidity as time goes on, since inflammation and infection can develop. This study reports a 3-day-old female neonate who presented with genital prolapse associated with meningomyelocele, which was successfully treated with bottle nipple support left for 5 days...

CONCLUSIONS: vNOTES High USLS appears to be a feasible and safe mesh-free alternative for advanced apical prolapse. Larger prospective studies are needed to confirm long-term outcomes.

<b>Introduction:</b> Full-thickness rectal prolapse (FTRP) is a multifactorial disease that can be treated with different surgicaltechniques. There is still no standard surgical procedure, and the selection of the surgical technique is based on the individualassessment and the experience of the surgeon. The benefits to patients should focus on repair of bowel prolapse, reduction ofconstipation, and an improvement in pelvic floor muscle insufficiency.<b>Aim:</b> Aim of...

Pelvic organ prolapse (POP) repair using synthetic mesh introduces mechanical mismatches that significantly influence fibroblast behavior. As the primary mechanosensitive cells in vaginal connective tissue, fibroblasts respond to extracellular stiffness via mechanotransduction pathways, such as focal adhesions (FAs), transforming growth factor β (TGF-β) signaling, and others. These pathways regulate key cellular responses, including proliferation, apoptosis, and differentiation into...

CONCLUSIONS: An advanced stage of anterior compartment prolapse was the main factor that affected VD and OAB in women with POP.

CONCLUSIONS: Women showed significant enhancement in sexual function after receiving either posterior pelvic organ prolapse repair or a combination of posterior and anterior repair.

By employing network pharmacology and molecular docking techniques, this study seeks to elucidate the targets and molecular mechanisms of Bu-Zhong-Yi-Qi decoction (BZYQD) in the management of pelvic organ prolapse (POP). Active components of BZYQD were identified via liquid chromatography-tandem mass spectrometry analysis and matched with potential targets in POP utilizing databases like Swiss Target Prediction, Gene Expression Omnibus, and "Disease" + "Gene" + "NETwork" (DisGeNET). The...

CONCLUSIONS: Preoperative UTI was associated with an increased risk of deep/organ space surgical site infection, perioperative transfusion, sepsis, readmission, and reoperation in the 30 days after surgery. However, overall 30-day complication rates were similar between groups. Postponing elective prolapse surgery for patients with a UTI may improve perioperative outcomes.

CONCLUSION: Patients with IBD have increased GI complication risks after prolapse surgery compared with patients without IBD.

CONCLUSION: The developed phantom enables realistic, structured training in presacral dissection and mesh fixation, supporting skill acquisition outside the operating room. Clinical Impact-By providing a cost-effective, reusable, and anatomically faithful simulator, this work contributes to safer training in gynecology and pelvic floor surgery, with potential integration into competency-based curricula and dry-lab facilities.

CONCLUSIONS: No differences in pain scores, opiate consumption, time to first narcotic dose, or hospital length of stay were observed between the treatment and placebo groups. The routine use of intraperitoneal bupivacaine following POP surgery appears to have limited clinical utility.

CONCLUSION: Reduced levels of circulating androgens, particularly Salivary free testosterone, may be associated with POP development and severity. Salivary free testosterone could serve as a non-invasive biomarker for POP risk stratification. Further longitudinal and multi-institutional studies are needed to clarify the role of androgens in POP pathophysiology.

CONCLUSION: A prolonged SSL (≥ 3 h) is associated with weaker PFM strength, greater muscle fatigue, enlarged levator hiatus, and a higher incidence of POP in primiparous women delivering macrosomic foetuses.

CONCLUSIONS: Preoperative UDS in women with POP stages III - IV increases diagnostic yield, influences surgical planning, and raises the number of concomitant sling procedures. However, it does not alter postoperative outcomes in patients deemed continent on PE.

The biomechanical mechanism between genital hiatus (GH), intra-abdominal pressure (IAP) and pelvic organ prolapse (POP) is currently unclear. Therefore, two biomechanical models for comparative analysis are developed to discuss the biomechanical relations of IAP and GH with prolapse of anterior and posterior vaginal walls (AVW and PVW) in the injured pelvic floor system. Based on the magnetic resonance imaging (MRI) of the pelvic floor of a healthy woman, we developed two 2D finite element...

Background and Objectives: The close anatomical relationship between pelvic support structures and the lower urinary tract contributes to high rates of urinary dysfunction among patients with pelvic organ prolapse (POP). POP reduction alone has been shown to alter urinary tract functioning. The aim of this study was to assess urinary functioning outcomes following a novel reconstructive surgical technique for POP. Materials and Methods: This randomized controlled trial was conducted between...

Background and Objectives: After the publication by Haylen et al. introducing the MUSPACC (midline uterosacral plication anterior colporrhaphy combination) procedure, we implemented this technique in our clinical practice for the treatment of cystocele and vaginal vault prolapse (VVP). The aims of this study were to evaluate peri- and postoperative complications, as well as vaginal and urinary symptoms, including patient satisfaction 3 months postoperatively. Materials and Methods: A...

This case report demonstrates the removal of an intravesical Gellhorn pessary and management of a large vesicovaginal fistula. A 79-year-old woman with a history of pelvic organ prolapse treated with a Gellhorn pessary three years prior presented with recurrent urinary tract infections and continuous urinary leakage. CT imaging showed the pessary to be intravesical. After surgical clearance, she underwent cystoscopy and vaginoscopy under anesthesia with the goal of transvaginal removal. The...

CONCLUSIONS: Ring pessary therapy is a useful conservative treatment option for Japanese women with POP. SM may facilitate successful fitting and prolonged continuation when appropriate patient instruction and follow-up are provided.

CONCLUSION: TVM continues to be a reliable and effective option for POP management. Taiwan's experience highlights the importance of proper training, patient selection, and surgical refinement in minimizing complications. Long-term follow-up and awareness of red-flag symptoms remains essential.

CONCLUSION: This study shows that combined surgery for treatment of POP and SUI is more efficient than staged one, in 12-months follow-up period. Furthermore, patients with occult SUI had better outcome than those with overt SUI.

BACKGROUND: Anterior compartment prolapse is the most common pelvic organ prolapse. Clinicians have utilised various surgical techniques to minimise the rate of recurrent pelvic organ prolapse (POP).

CONCLUSION: The available literature is limited to small, mostly single-arm studies with short- to medium-term follow-up. Key gaps include a lack of direct comparative trials with mesh, long-term durability data, and standardised outcome reporting.

CONCLUSION: Our study highlights the complexity of women's sexual experiences before and after POP surgery. Clinical counseling around the impact of surgical repair of POP on sexual activity should include expectation management, including the timeline for recovery and which aspects of sexuality may improve.

CONCLUSIONS: Compared with vaginal wall repair alone, the combined approach of laparoscopic suspension and vaginal wall repair improves postoperative pelvic floor function and quality-of-life outcomes without increasing the risk of complications, supporting its role as a valuable surgical option for selected patients with POP.

CONCLUSIONS: Colpocleisis is a safe and highly effective procedure for selected patients with advanced POP especially during the current emphasis on native tissues repairs for POP, offering durable anatomical outcomes, high satisfaction, and low regret rates. Preoperative urodynamic findings and obesity are important predictors of persistent urinary symptoms and should be considered during patient counselling and surgical planning.

CONCLUSIONS: Obesity was not associated with increased postoperative complications 30 days after surgery following uterine-preserving apical prolapse repair. However, anatomical success was significantly lower among women with BMI > 30. These findings should be interpreted cautiously given the unequal group sizes and heterogeneity of the cohort.

CONCLUSIONS: VH for advanced POP demonstrated favorable perioperative outcomes with a low complication rate. Age, parity, and concomitant procedures influenced perioperative measures, supporting VH with apical suspension as a reliable real-world surgical option.

CONCLUSIONS: Transobturator paravaginal repair demonstrated favorable short-term anatomical outcomes for both anterior and apical compartments with minimal morbidity. Although these early results are promising, longer follow-up is necessary to confirm long-term durability and recurrence rates.

CONCLUSIONS: In this nationwide retrospective cohort study, VMR was associated with favorable functional outcomes in males. Recurrence rates were significantly higher in those with internal rectal prolapse. As sexual function was not systematically assessed, prospective studies with standardized patient-reported outcomes are warranted.

Pelvic organ prolapse (POP) is commonly managed with transvaginal hysterectomy (TVH) and pelvic floor repair. As the population ages, the need for POP surgery continues to increase, typically under either spinal or general anesthesia. Although spinal anesthesia is associated with fewer postoperative complications, concerns regarding postoperative urinary retention (POUR) remain. This study was designed to investigate whether the type of anesthesia influences the incidence of POUR in POP surgery....

We report a case of bladder diverticulum accompanied by pelvic organ prolapse treated with laparoscopic sacrocolpopexy and bladder diverticulectomy at the same time. A literature search showed this is the first report of simultaneous laparoscopic bladder diverticulectomy and sacrocolpopexy. A 63-year-old woman was referred to our department for voiding dysfunction and incomplete bladder emptying. She had a POP-Q stage III cystocele. Magnetic resonance imaging showed a large bladder diverticulum....

This case report describes the successful application of video-assisted hysteroscopy to evaluate endometrial recovery in a 6-year-old mare following treatment for complete uterine prolapse secondary to dystocia. Upon presentation, the uterus was manually reduced and supported with a Buhner's suture. A multimodal medical protocol, including broad-spectrum antibiotics, anti-inflammatory drugs and uterine lavage, was initiated. Five days after reduction, an endoscopic evaluation was performed using...

CONCLUSIONS: Rectal stump symptomatology is common in patients undergoing a defunctioning stoma for benign functional anorectal conditions. Many of these patients require ongoing management to control their symptoms, including in some cases a completion proctectomy. This study forms the basis for further research on rectal stump symptomatology in this complex cohort of patients.

CONCLUSIONS: Most women attending a PMCC reported a variety of urogynaecological and pain symptoms, requiring an evidence-based, timely, individualised and multidisciplinary management approach.

CONCLUSIONS: Through an iterative process, we have identified a list of themes that can guide international collaboration on outcomes research during the next decade. See Video Abstract .

CONCLUSIONS: The burden of genital prolapse among women aged 20-54 years decreased globally, though marked geographic and socioeconomic disparities persist. Population growth remains the leading driver, underscoring the need for targeted prevention and resource allocation.

CONCLUSION: Both LLS and vNOTES-LS are effective and safe techniques for POP repair. vNOTES-LS appears to provide superior anatomical outcomes and lower reoperation rates, particularly uterine-preserving cases, supporting its broader adoption in minimally invasive pelvic reconstructive surgery.

CONCLUSIONS: The decision to undergo vaginal closure is unique to each patient, but with common themes. Surgeon counseling is highly influential on patient evaluation of their options and anticipated outcomes. The risk of regret appears minimal, suggesting that thorough counseling and appropriate patient selection are highly effective.

CONCLUSIONS: Most women felt recovered within 1 week after MUS surgery and 2 weeks after POP surgery, supporting evidence-based, unrestricted postoperative activity instructions after urogynecologic surgery.

CONCLUSION: Decreasing insufflation pressure by 3 mm Hg resulted in decreased postoperative pain without compromising surgeon visibility.

CONCLUSION: Our model suggests that SCH-SCP may be cost-effective compared with MISH. SCH-SCP decreases the number of additional major surgical procedures, endometrial cancer diagnoses, and endometrial cancer deaths in our analysis.

CONCLUSIONS: Mesh-based and mesh-free pectopexy both offer effective anatomical correction and functional recovery in apical prolapse surgery. Mesh-based techniques provide stronger apical support, while mesh-free approaches may be preferable for patients avoiding synthetic implants. Individualized surgical planning remains essential.

CONCLUSIONS: Adherence to national guidance for pelvic floor disorder management in primary care was suboptimal, particularly for pelvic organ prolapse. Older women showed higher unadjusted odds of referral without full conservative management on univariable analyses. These findings support targeted education, clearer referral pathways, and improved access to community pelvic health services to optimise referral quality.

To explore the correlation between serum interleukins and postoperative recurrence of pelvic organ prolapse (POP). Additionally, a predictive model incorporating both clinical parameters and inflammatory markers was developed to support individualized recurrence prevention and management strategies. The analysis included 184 patients who underwent POP surgery between March 2022 and June 2024. Among them, 44 experienced recurrence (recurrence group), while 140 did not (non-recurrence group). The...

This study evaluates the impact of different surgical methods on sexual function and partner satisfaction in women with isolated apical pelvic organ prolapse. It compares uterus-sparing procedures (laparoscopic lateral mesh suspension [LLMS] and laparoscopic uterosacral ligament suspension [LUSLS]) with vaginal hysterectomy (VH) and bilateral sacrospinous ligament fixation (SSLF). This retrospective study included 20 patients with isolated apical uterine prolapse between March 2020 and March...

Pelvic organ prolapse (POP), a prevalent gynecological disorder affecting 41-50% of women globally, causes significant quality-of-life deterioration. While nondegradable polypropylene mesh (PPM) reduces surgical recurrence rates, its utility is restricted by complications including erosion, infection, and chronic inflammation. Strategic modulation of inflammatory homeostasis and neovascularization has emerged as a critical pathway to mitigate these sequelae. Here, we engineered a microporous and...