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Pelvic Organ Prolapse: Current Progress and Clinical Challenges, 2nd Edition

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Obstetrics & Gynecology".

Deadline for manuscript submissions: 25 December 2026 | Viewed by 120

Special Issue Editors


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Guest Editor
Department of Urology, Sapienza University of Rome, 00189 Rome, Italy
Interests: prostate; urodynamics; prostate cancer; urologic oncology; bladder cancer; urology surgery
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Special Issue Information

Dear Colleagues,

It is my pleasure to invite you to contribute to the Special Issue entitled “Pelvic Organ Prolapse: Current Progress and Clinical Challenges, 2nd Edition”. Five papers were published in the first edition. For more details, please visit: https://www.mdpi.com/journal/jcm/special_issues/2NER2H42C4.

Pelvic organ prolapse (POP) is a significant health concern, affecting a substantial proportion of women, particularly during postmenopausal and post-childbirth phases. It occurs when pelvic organs like the bladder, uterus or rectum drop from their normal position and bulge into the vagina due to weakening of the muscles and tissues supporting these organs. This condition can cause discomfort, urinary problems and sexual dysfunction, severely impacting quality of life. 

Recent progress in understanding and managing POP includes advancements in diagnostic techniques, such as high-resolution imaging, which provides a detailed view of pelvic anatomy and helps in precise identification of the prolapse. There has also been development in minimally invasive surgical techniques, such as laparoscopic and robotic surgeries, which offer quicker recovery and fewer complications compared to traditional surgeries. 

However, clinical challenges remain. These include a need for better risk prediction and prevention strategies, especially for women at higher risk due to genetic factors or lifestyle. Additionally, the long-term efficacy and safety of surgical mesh, used in POP surgeries, are under scrutiny due to complications like mesh erosion. Thus, current research is also focused on developing new biomaterials for safer and more effective treatments. 

Overall, while significant strides have been made in the treatment and management of POP, ongoing research and clinical trials are crucial for addressing the remaining challenges and improving patient outcomes.

Dr. Riccardo Lombardo
Dr. Cosimo De Nunzio
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • pelvic organ prolapse (POP)
  • postmenopausal
  • urinary dysfunction
  • minimally invasive surgery
  • laparoscopic sur-gery
  • robotic surgery
  • surgical mesh

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Published Papers (1 paper)

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Research

12 pages, 2607 KB  
Article
The Role of 3D/4D Transperineal Ultrasound in Risk Stratification for Pelvic Organ Prolapse Recurrence: Native Tissue Versus Mesh Repair
by José Antonio García-Mejido, María José Nuñez-Matas, Olaya Salas-Álvarez, Alejandro Crespo-Rodriguez, Ana Fernández-Palacín and José Antonio Sainz-Bueno
J. Clin. Med. 2026, 15(12), 4627; https://doi.org/10.3390/jcm15124627 (registering DOI) - 14 Jun 2026
Abstract
Background/Objectives: Pelvic organ prolapse (POP) management requires precise patient selection for surgical techniques to balance clinical efficacy and safety. The primary aim of this study was to evaluate the role of preoperative 3D/4D transperineal ultrasound in the risk stratification of POP recurrence. [...] Read more.
Background/Objectives: Pelvic organ prolapse (POP) management requires precise patient selection for surgical techniques to balance clinical efficacy and safety. The primary aim of this study was to evaluate the role of preoperative 3D/4D transperineal ultrasound in the risk stratification of POP recurrence. We analyzed the impact of levator ani muscle (LAM) injuries, specifically avulsion and ballooning, as identified by ultrasound, on both anatomical and subjective success rates, comparing native tissue repair versus mesh-augmented surgery. Methods: A prospective, multicenter observational study was conducted over a five-year period, January 2021 to December 2024 (recruitment), with follow-up completed in December 2025, ensuring a minimum follow-up of 12 months for all participants. The cohort included 276 women scheduled for primary surgery for symptomatic POP stage ≥ 2. Prior to intervention (116 underwent native tissue repair and 160 received mesh), all patients underwent 3D/4D transperineal ultrasound for standardized volume acquisition. Using this preoperative functional imaging technique, we measured the hiatal area and diagnosed the presence of hiatal ballooning (≥25.0 cm2) or levator muscle avulsion. Results: Ultrasound assessment revealed significant differences in surgical success based on the diagnosed baseline site-specific defects. Hiatal ballooning was the sonographic finding that demonstrated the greatest impact on risk stratification. Among patients with preoperative ballooning, mesh use significantly reduced both subjective recurrence (5.7% vs. 21.4%, p = 0.001) and objective recurrence (21.4% vs. 35.7%, p = 0.040) compared to native tissue repair. Furthermore, in women without ultrasound-documented avulsion, mesh also decreased objective recurrence (17.9% vs. 33.0%, p = 0.024). Multivariate analysis, adjusted for age, BMI, menopausal status, and parity, confirmed that, after stratifying by these preoperative ultrasound findings, a native tissue approach remains the primary independent predictor of surgical failure (OR 1.752 for objective recurrence; p = 0.041). Conclusions: In conclusion, native tissue repair was identified as the primary independent predictor of surgical failure. While 3D/4D transperineal ultrasound helps identify high-risk phenotypes such as hiatal ballooning, these sonographic findings did not maintain independent significance in the multivariate model. Therefore, ultrasound should be considered a complementary tool for surgical planning rather than a definitive predictor of recurrence. Full article
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