Pelvic Organ Prolapse: Current Challenges and Future Perspectives
Keywords:
Pelvic organ prolapse, hysterectomy, connective tissue dysplasia, recurrence, POP-Q system, reconstructive surgery, vaginal cuff prolapseAbstract
Pelvic organ prolapse (POP) remains a predominant gynecological pathology that significantly impairs quality of life and sexual function, with prevalence rates rising proportionally with age. Despite extensive research, treatment efficacy is often compromised by high recurrence rates of up to 33.3%, and the pathogenesis of vaginal cuff and cervical stump prolapse following hysterectomy remains insufficiently addressed in current literature. This review analyzes the etiology, classification, and management of POP, focusing on the impact of connective tissue dysplasia, hypoestrogenism, and anatomical distortion on surgical outcomes. The findings indicate that the loss of the natural suspensory and anchoring ligamentous apparatus during hysterectomy is a critical driver of secondary prolapse, exacerbated by collagen defects and metabolic disturbances. Consequently, improving clinical outcomes requires an individualized surgical approach that prioritizes the restoration of all weakened ligamentous components during the primary intervention to mitigate the risk of recurrence and functional disability.
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