{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T07:42:41Z","timestamp":1791013361941,"version":"4.1.0"},"reference-count":29,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T00:00:00Z","timestamp":1783555200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>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).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>\n                      This retrospective study analyzed the clinical data of 135 patients with POP-Q stage\u2009\u2265\u2009III who underwent pelvic floor biomechanical reconstruction between January 2022 and December 2023. Based on preoperative symptoms and urodynamics, patients were classified as occult stress urinary incontinence (OSUI,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200932), no SUI with negative urodynamics (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200941), and clinically confirmed SUI (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200962). Follow-up assessments were conducted at 3 months, 1 year, and 2 years postoperatively. Outcomes included POP-Q indicators (Aa, Ba, C, D, Ap, Bp, Gh, Pb, TVL), the Pelvic Floor Distress Inventory-20 (PFDI-20), and the Patient Global Impression of Improvement (PGI-I). Transperineal three-dimensional ultrasound was performed preoperatively and at 3 months postoperatively to measure the urethral rotation angle (URA), retrovesical angle (RVA), bladder neck descent (BND), and levator hiatus area (LHA). Perioperative and follow-up complications, POP recurrence, and SUI outcomes were also recorded.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      All procedures were completed successfully. All POP-Q indicators improved significantly at 3 months, 1 year, and 2 years compared with baseline (all\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001). At 3 months, ultrasound parameters decreased significantly (URA 81.5\u2009\u00b1\u200925.9\u00b0 to 38.0\u2009\u00b1\u200913.7\u00b0; RVA 164.7\u2009\u00b1\u200919.5\u00b0 to 106.9\u2009\u00b1\u200918.9\u00b0; BND 37.1\u2009\u00b1\u200913.3 to 12.7\u2009\u00b1\u20096.6\u2005mm; LHA 30.7\u2009\u00b1\u20095.2 to 17.2\u2009\u00b1\u20094.8 cm\n                      <jats:sup>2<\/jats:sup>\n                      ; all\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.05). PFDI-20 scores decreased from 144.6\u2009\u00b1\u200944.5 preoperatively to 52.1\u2009\u00b1\u200921.3 (3 months), 13.7\u2009\u00b1\u200911.1 (1 year), and 8.1\u2009\u00b1\u20098.5 (2 years) (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001). At 2 years, 94.8% of patients reported \u201cvery much improved\u201d or \u201cmuch improved\u201d. Overall postoperative SUI symptom rate was 3.7%. POP recurrence occurred in 2.2%. Major adverse events were uncommon: intraoperative complications 3.0% and mesh exposure 1.5%.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Pelvic floor biomechanical reconstruction provides durable anatomical correction with favorable continence outcomes and low recurrence, with manageable morbidity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fsurg.2026.1828203","type":"journal-article","created":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T05:34:27Z","timestamp":1783575267000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Pelvic floor biomechanical reconstruction for moderate to severe pelvic organ prolapse: two-year outcomes of anatomical restoration and urinary continence"],"prefix":"10.3389","volume":"13","author":[{"given":"Jihong","family":"Shen","sequence":"first","affiliation":[{"name":"Department of Urology, The First Affiliated Hospital of Kunming Medical University","place":["Kunming, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xunguo","family":"Yang","sequence":"additional","affiliation":[{"name":"Southern Hospital of Southern Medical University","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenhua","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Urology, The First Affiliated Hospital of Kunming Medical University","place":["Kunming, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Urology, The First Affiliated Hospital of Kunming Medical University","place":["Kunming, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daoming","family":"Tian","sequence":"additional","affiliation":[{"name":"Department of Urology, The First Affiliated Hospital of Kunming Medical University","place":["Kunming, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Urology, The First Affiliated Hospital of Kunming Medical University","place":["Kunming, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiangna","family":"Gu","sequence":"additional","affiliation":[{"name":"Department of Urology, The First Affiliated Hospital of Kunming Medical University","place":["Kunming, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongcheng","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Urology, The First Affiliated Hospital of Kunming Medical University","place":["Kunming, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qian","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Urology, The First Affiliated Hospital of Kunming Medical University","place":["Kunming, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xingqi","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Urology, The First Affiliated Hospital of Kunming Medical University","place":["Kunming, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,9]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"3122","DOI":"10.1016\/j.mayocp.2021.09.005","article-title":"Evaluation and management of pelvic organ prolapse","volume":"96","author":"Raju","year":"2021","journal-title":"Mayo Clin Proc"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1559","DOI":"10.1007\/s00192-015-2695-8","article-title":"Risk 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