Pelvic organ prolapse: modern diagnostic and treatment strategies

Abstract

Despite the close attention of gynecologists, coloproctologists and urologists, the diagnosis and complex treatment of pelvic organ prolapse and associated anatomical and functional disorders remains a relevant and not fully resolved problem, requiring a multidisciplinary approach to its solution. The purpose of this literature review is to analyze and systematize current literature data on modern methods of diagnosis, conservative and surgical treatment used to correct pelvic organ prolapse. This article is intended for specialists who diagnose and correct diseases of the pelvic floor and perianal area. The most relevant and common gynecological, coloproctological and urological problems of pelvic organ prolapse, including rectocele and urinary incontinence, are discussed. Methods of diagnosis and conservative treatment, various options for surgical correction and tactical approaches to their selection, including the use of 3D technologies, are presented. Modern positions on the method of strengthening the pelvic floor using mesh implants installed through the vagina (MESH technology) are discussed. Particular attention is paid to the points of interaction between related specialists specializing in the treatment of various pelvic floor systems, and the need for their joint participation in the treatment and diagnostic process to exchange experience and improve the quality of medical care. Only a comprehensive multidisciplinary approach can improve the results of surgical treatment of pelvic organ prolapse, reduce the risk of intraoperative complications, long-term unfavorable results and the frequency of disease relapses. The introduction of preoperative personalized 3D modeling, planning and surgical navigation makes it possible to develop optimal tactics for surgical intervention and its implementation taking into account individual topographical features. This will help reduce intraoperative trauma and complications and creates a practical basis for conducting operations within the frame-work of Fast Track technologies.