{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T17:16:56Z","timestamp":1777483016062,"version":"3.51.4"},"reference-count":24,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T00:00:00Z","timestamp":1753315200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Pelvic floor disorders (PFDs) have multifactorial etiology. This makes treatment challenging and often unsatisfactory. This project introduces robust data on risk factors for PFDs and explores opportunities for their prevention, focusing on previous gynecological surgical interventions. Methods: We conducted a retrospective analytical cohort study analyzing demographic and clinical data from 832 consecutive patients who underwent pelvic organ prolapse (POP) surgery at a teaching hospital affiliated with the University of Cologne between 2010 and 2019. Patient characteristics\u2014including age, body mass index (BMI), parity, mode of delivery, and symptoms\u2014were collected from medical records. Associations between patient factors and surgical history were assessed using Kendall\u2019s Tau (KT) for correlations and relative risks (RRs) with 95% confidence intervals (CIs) to evaluate the impact of previous hysterectomies and pelvic surgeries on PFD. Results: First vaginal delivery and age were the strongest factors associated with PFD. BMI had a smaller impact, and multiple vaginal deliveries did not significantly influence apical (KT 0.037), posterior (KT 0.007), anterior midline (KT 0.015), or lateral defects (KT 0.015). Cesarean section was protective. Subtotal hysterectomy showed no significant association with PFD. Total hysterectomy was strongly associated with posterior defects (RR 4.750, 95% CI: 1.871\u201312.059) and anterior midline defects (RR 1.645, 95% CI: 0.654\u20134.139). Recurrent urinary infections were associated with abdominal colposuspension (RR 4.485, 95% CI: 1.12\u201318.03). Dyspareunia occurred more frequently after vaginal (RR 3.971, 95% CI: 0.78\u201320.14) and abdominal hysterectomy (RR 1.620, 95% CI: 0.32\u20138.15). Vaginal hysterectomy was linked to fecal incontinence (RR 5.559, 95% CI: 1.17\u201326.30), MUI (RR 2.156, 95% CI: 1.09\u20134.23), and UUI (RR 4.226, 95% CI: 1.82\u20136.85). Conclusions: The factors identified as influencing (PFD) offer a solid foundation for evidence-based patient counseling within our population. Our large dataset confirmed key risk factors, notably childbirth and advancing age. However, the influence of BMI on symptoms and anatomical defects appears to be less significant than previously assumed. Subtotal hysterectomy was not associated with new PFD in our cohort and may represent a viable option when hysterectomy is indicated, though further studies are needed to confirm this potential advantage.<\/jats:p>","DOI":"10.3390\/jcm14155244","type":"journal-article","created":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T14:11:44Z","timestamp":1753366304000},"page":"5244","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Impact of Gynecological Interventions on Pelvic Floor Disorders: A Descriptive Analysis of a Case Series in a Hospital-Based Surgical Cohort of 832 Patients"],"prefix":"10.3390","volume":"14","author":[{"given":"G\u00fcnter","family":"No\u00e9","sequence":"first","affiliation":[{"name":"Department of OB\/GYN, University of Witten Herdecke, 58448 Witten, Germany"},{"name":"Department of OB\/GYN, Rheinland Klinikum Dormagen, Dr.-Geldmacher-Strasse 20, 41540 Dormagen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nele","family":"Ziems","sequence":"additional","affiliation":[{"name":"Department of OB\/GYN, Rheinland Klinikum Dormagen, Dr.-Geldmacher-Strasse 20, 41540 Dormagen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-5363-3522","authenticated-orcid":false,"given":"Anna","family":"Pitsillidi","sequence":"additional","affiliation":[{"name":"Department of OB\/GYN, Rheinland Klinikum Dormagen, Dr.-Geldmacher-Strasse 20, 41540 Dormagen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7194-6034","authenticated-orcid":false,"given":"Ibrahim","family":"Alkatout","sequence":"additional","affiliation":[{"name":"Department of OB\/GYN, University of Kiel, 24118 Kiel, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1013-8455","authenticated-orcid":false,"given":"Dusan","family":"Djokovic","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Hospital CUF Descobertas, Rua M\u00e1rio Botas S\/N, 1998-018 Lisbon, Portugal"},{"name":"Department of Obstetrics and Gynecology, NOVA Medical School\u2014Faculdade de Ci\u00eancias M\u00e9dicas, NOVA University of Lisbon, Campo dos M\u00e1rtires da P\u00e1tria 130, 1169-056 Lisboa, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Wang, B., Chen, Y., Zhu, X., Wang, T., Li, M., Huang, Y., Xue, L., Zhu, Q., Gao, X., and Wu, M. (2022). Global Burden and Trends of Pelvic Organ Prolapse Associated with Aging Women: An Observational Trend Study from 1990 to 2019. Front. Public Health, 10.","DOI":"10.3389\/fpubh.2022.975829"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"(2020). Physical Activity and Exercise During Pregnancy and the Postpartum Period. Obstet. Gynecol., 135, e178\u2013e188.","DOI":"10.1097\/AOG.0000000000003772"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"469580231219155","DOI":"10.1177\/00469580231219155","article-title":"Pelvic Organ Prolapse and Its Associated Factors Among Women: A Facility Based Cross-Sectional Study","volume":"60","author":"Merga","year":"2023","journal-title":"INQUIRY J. Health Care Organ. Provis. Financ."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"664.e1","DOI":"10.1016\/j.ajog.2007.08.064","article-title":"Incidence of Pelvic Floor Repair after Hysterectomy: A Population-Based Cohort Study","volume":"197","author":"Blandon","year":"2007","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2705","DOI":"10.1007\/s00404-024-07615-x","article-title":"Recurrent Pelvic Organ Prolapse after Hysterectomy; a 10-Year National Follow-up Study","volume":"310","author":"Kuittinen","year":"2024","journal-title":"Arch. Gynecol. Obstet."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Vermeulen, C.K.M., Veen, J., Adang, C., Coolen, A.L.W.M., van Leijsen, S.A.L., and Bongers, M.Y. (2023). Long-Term Pelvic Floor Symptoms and Urogenital Prolapse after Hysterectomy. BMC Womens Health, 23.","DOI":"10.1186\/s12905-023-02286-3"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1632","DOI":"10.1016\/j.ajog.2003.09.010","article-title":"Adoption of the Pelvic Organ Prolapse Quantification System in Peer-Reviewed Literature","volume":"189","author":"Muir","year":"2003","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_8","first-page":"75","article-title":"Pelvic Organ Prolapse Quantification System (POP-Q)\u2014A New Era in Pelvic Prolapse Staging","volume":"4","author":"Persu","year":"2011","journal-title":"J. Med. Life"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Peinado-Molina, R.A., Hern\u00e1ndez-Mart\u00ednez, A., Mart\u00ednez-V\u00e1zquez, S., Rodr\u00edguez-Almagro, J., and Mart\u00ednez-Galiano, J.M. (2023). Pelvic Floor Dysfunction: Prevalence and Associated Factors. BMC Public Health, 23.","DOI":"10.1186\/s12889-023-16901-3"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1016\/j.ajog.2023.11.1253","article-title":"Pelvic Floor Injury during Vaginal Birth Is Life-Altering and Preventable: What Can We Do about It?","volume":"230","author":"DeLancey","year":"2024","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1097\/GCO.0b013e328357628b","article-title":"Pelvic Floor Disorders Following Vaginal or Cesarean Delivery","volume":"24","author":"Memon","year":"2012","journal-title":"Curr. Opin. Obstet. Gynecol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1016\/j.tjog.2014.08.001","article-title":"Pelvic Floor Dysfunction, and Effects of Pregnancy and Mode of Delivery on Pelvic Floor","volume":"53","author":"Bozkurt","year":"2014","journal-title":"Taiwan J. Obstet. Gynecol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"777","DOI":"10.1097\/AOG.0b013e3182267f2f","article-title":"Pelvic Floor Disorders 5\u201310 Years After Vaginal or Cesarean Childbirth","volume":"118","author":"Handa","year":"2011","journal-title":"Obstet. Gynecol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1111\/aogs.14027","article-title":"Pregnancy- and Obstetric-related Risk Factors for Urinary Incontinence, Fecal Incontinence, or Pelvic Organ Prolapse Later in Life: A Systematic Review and Meta-analysis","volume":"100","author":"Wiezer","year":"2021","journal-title":"Acta Obstet. Gynecol. Scand."},{"key":"ref_15","first-page":"93","article-title":"Vaginal Parity and Pelvic Organ Prolapse","volume":"55","author":"Quiroz","year":"2010","journal-title":"J. Reprod. Med."},{"key":"ref_16","first-page":"265","article-title":"Vaginal Childbirth and Pelvic Floor Disorders","volume":"9","author":"Memon","year":"2013","journal-title":"Women\u2019s Health"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1559","DOI":"10.1007\/s00192-015-2695-8","article-title":"Risk Factors for Pelvic Organ Prolapse and Its Recurrence: A Systematic Review","volume":"26","author":"Vergeldt","year":"2015","journal-title":"Int. Urogynecol. J."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1016\/j.ajog.2022.04.046","article-title":"Risk Factors for Primary Pelvic Organ Prolapse and Prolapse Recurrence: An Updated Systematic Review and Meta-Analysis","volume":"227","author":"Schulten","year":"2022","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1007\/s00192-021-04826-7","article-title":"The Distribution of Pelvic Organ Support Defects in Women Undergoing Pelvic Organ Prolapse Surgery and Compartment Specific Risk Factors","volume":"33","author":"Boulvain","year":"2022","journal-title":"Int. Urogynecol. J."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1186\/s12978-021-01104-z","article-title":"The Effect of Women\u2019s Body Mass Index on Pelvic Organ Prolapse: A Systematic Review and Meta Analysis","volume":"18","author":"Zenebe","year":"2021","journal-title":"Reprod. Health"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1016\/j.ejogrb.2018.10.058","article-title":"Evidence-Based Guidelines for Vaginal Hysterectomy of the International Society for Gynecologic Endoscopy (ISGE)","volume":"231","author":"Chrysostomou","year":"2018","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1016\/j.ejogrb.2023.10.016","article-title":"The Routes of Hysterectomy: A Survey of Current Practices amongst Members of the International Society for Gynaecologic Endoscopy (ISGE)","volume":"291","author":"Djokovic","year":"2023","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"ref_23","first-page":"CD003677","article-title":"Surgical Approach to Hysterectomy for Benign Gynaecological Disease","volume":"2015","author":"Aarts","year":"2015","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"774","DOI":"10.1111\/aogs.14561","article-title":"Hysterectomy on Benign Indication and Risk of Pelvic Organ Prolapse Surgery: A National Matched Cohort Study","volume":"102","author":"Aagesen","year":"2023","journal-title":"Acta Obstet. Gynecol. Scand."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/15\/5244\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:15:27Z","timestamp":1760033727000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/15\/5244"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,24]]},"references-count":24,"journal-issue":{"issue":"15","published-online":{"date-parts":[[2025,8]]}},"alternative-id":["jcm14155244"],"URL":"https:\/\/doi.org\/10.3390\/jcm14155244","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,24]]}}}