Surgical approaches to pelvic floor reconstruction among patients with pelvic organ prolapse and voiding dysfunction: a systematic review of functional outcomes and quality of life

Resumo

Since midlife women experience pelvic organ prolapse (POP) and voiding dysfunction (VD) which highly affects their quality of life. POP affects nearly fifty percent of women older than fifty and these patients often concurrently experience urinary retention together with incomplete bladder emptying. The necessity of surgical reconstruction steps in when conservative treatments prove unable to resolve the issue. The review systematizes analysis of procedures used for pelvic function recovery and improved patient life quality assessment. Researchers carried out the review which adhered to PRISMA 2020 guidelines while analyzing data spanning from 2000 to 2025. The study included both cohort studies and randomized trials that investigated women who received vaginal or laparoscopic or robotic or combination pelvic floor surgeries. Academic researchers studied quality of life and functional outcomes that included urinary retention together with de novo stress incontinence and overactive bladder using PFDI-20 and PISQ-12 measurement tools. The success rates of laparoscopic and robotic sacrocolpopexy surgery reach 90–95% for long-term outcomes by using mininally invasive mesh procedures that address pelvic organ issues. These procedures demonstrate better success than traditional vaginal approaches. The effectiveness of vaginal repairs remains significant for both elderly patients and those considered medically high-risk because they provide solid results despite higher chance of issues returning. The combination of mid-urethral slings used before surgery effectively lowers the probabilities of new postoperative urinary incontinence and retention. The satisfaction levels of patients directly depend on how their symptoms improve alongside how providers handle their treatment expectations. The surgical procedure of sacrocolpopexy generates useful effects on overactive bladder symptoms in 60% of cases but ongoing clinical studies show it induces urgency symptoms. The surgical strategy requires personalization to match patients' age with their risk levels and functional requirements using shared healthcare decisions which determine pelvic floor reconstruction plans.