{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T22:56:57Z","timestamp":1769554617445,"version":"3.49.0"},"reference-count":27,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T00:00:00Z","timestamp":1769126400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001826","name":"ZonMw, The Dutch Organisation for knowledge and innovation in health, healthcare and well-being","doi-asserted-by":"publisher","award":["10390012110093"],"award-info":[{"award-number":["10390012110093"]}],"id":[{"id":"10.13039\/501100001826","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Perineoplasty can be performed as an adjunct to native tissue pelvic organ prolapse (POP) surgery; the optimal indication for perineoplasty is unknown due to limited evidence regarding its benefits and the absence of clear clinical guidelines. This study aims to describe patient-related factors associated with surgeons\u2019 decisions to add perineoplasty to POP surgery and to quantify the frequency of intraoperative changes from preoperative surgical plans. Methods: In this multicenter observational cohort study, women \u2265 18 years scheduled for primary native tissue POP surgery between April 2023 and November 2024 were included. Baseline characteristics, pelvic floor anatomy (POP-Q), genital hiatus (GH), perineal body (PB) measurements, and surgeon-reported considerations regarding perineoplasty were collected. Surgical plans (\u201cwith\u201d, \u201cwithout\u201d, or \u201cundecided\u201d) were documented and compared with the actual performed procedure. Logistic and linear regression analyses were used to identify factors associated with perineoplasty. Results: Among the 305 enrolled women, 285 underwent surgery, of whom 135 (47%) received perineoplasty. Patients who underwent perineoplasty had a larger GH size (5.2 cm) compared to patients without perineoplasty (4.5 cm). Obesity was associated with an increased rate of perineoplasty compared to normal weight (OR 2.3 95%CI 1.2\u20134.6). There was a strong exponential association between childbirth and perineoplasty, with a fivefold increase for two children (95%CI 1.3\u201317.1) and thirtyfold increase for four or more children (95%CI 6.3\u2013142) compared to one child. Nearly all procedures (92%) followed the preoperative plan; surgeons were more likely to omit than add perineoplasty intraoperatively. Surgeons frequently reported GH\/PB size and age as key considerations to perform perineoplasty and lack of evidence and fear of dyspareunia as reasons to not perform perineoplasty. Conclusions: Surgeons more often perform perineoplasty in patients with factors that have been associated with a higher risk of recurrent prolapse. Prospective comparative studies are required to determine whether perineoplasty reduces recurrent POP after primary surgical repair.<\/jats:p>","DOI":"10.3390\/jcm15030916","type":"journal-article","created":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T09:21:40Z","timestamp":1769505700000},"page":"916","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Patient Factors Affecting Physicians\u2019 Decision to Add Perineoplasty to Pelvic Organ Prolapse Surgery: A Quantitative Analysis"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-4253-9182","authenticated-orcid":false,"given":"Esther C. A. M. van","family":"Swieten","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Spaarne Gasthuis, 2000 AK Haarlem, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-7610-9107","authenticated-orcid":false,"given":"Yasmina","family":"Chaghouaoui","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Spaarne Gasthuis, 2000 AK Haarlem, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3243-2970","authenticated-orcid":false,"given":"Karlijn J. van","family":"Stralen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Spaarne Gasthuis, 2000 AK Haarlem, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3069-6382","authenticated-orcid":false,"given":"Jan-Paul W. R.","family":"Roovers","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Amsterdam UMC, 1100 DD Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1007\/s00192-013-2141-8","article-title":"Management of Pelvic organ prolapse and quality of life: A systematic review and meta-analysis","volume":"25","author":"Doaee","year":"2014","journal-title":"Int. Urogynecol J."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Munno, G.M., La Verde, M., Lettieri, D., Nicoletti, R., Nunziata, M., Fasulo, D.D., Vastarella, M.G., Pennacchio, M., Scalzone, G., and Pieretti, G. (2023). Pelvic organ prolapse syndrome and lower urinary tract symptom update: What\u2019s new?. 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