Pelvic floor biomechanical reconstruction for moderate to severe pelvic organ prolapse: two-year outcomes of anatomical restoration and urinary continence - Summary - MDSpire
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Pelvic floor biomechanical reconstruction for moderate to severe pelvic organ prolapse: two-year outcomes of anatomical restoration and urinary continence
To evaluate the anatomical restoration, changes in urinary control function, and safety of pelvic floor biomechanical reconstruction in patients with moderate to severe pelvic organ prolapse (POP).
Approach:
Study Design: A retrospective analysis of 135 patients with POP-Q stage ≥ III who underwent pelvic floor biomechanical reconstruction between January 2022 and December 2023.
Patient Classification: Patients were classified based on preoperative symptoms and urodynamics into three groups: occult stress urinary incontinence (OSUI), no SUI with negative urodynamics, and clinically confirmed SUI.
Follow-Up Assessments: Follow-up assessments were conducted at 3 months, 1 year, and 2 years postoperatively, measuring various anatomical and functional outcomes.
Key Findings:
At 3 months, ultrasound parameters showed significant decreases: URA from 81.5 ± 25.9° to 38.0 ± 13.7°; RVA from 164.7 ± 19.5° to 106.9 ± 18.9°; BND from 37.1 ± 13.3 mm to 12.7 ± 6.6 mm; LHA from 30.7 ± 5.2 cm² to 17.2 ± 4.8 cm² (all P < 0.05).
Major adverse events were uncommon: intraoperative complications occurred in 3.0% of cases and mesh exposure in 1.5%.
Interpretation:
Pelvic floor biomechanical reconstruction provides durable anatomical correction with favorable continence outcomes and low recurrence.
Limitations:
Retrospective study design may introduce bias.
Single-center study limits generalizability of findings.
Conclusion:
Pelvic floor biomechanical reconstruction offers effective anatomical and functional outcomes for patients with moderate to severe POP.
