Search Results (526)

Background: Dyspareunia is a common female sexual pain disorder that significantly impairs quality of life. Despite the availability of evidence-based treatments, including multimodal pelvic floor physiotherapy and psychosexual interventions, patient awareness of these options remains insufficiently characterized. This study aimed to assess knowledge of dyspareunia management among affected women and to identify independent predictors of awareness. Methods: A cross-sectional survey was conducted in 2023 at the Central Clinical Hospital of the Medical University of Lodz, Poland, among 72 women with physician-confirmed dyspareunia. An 82-item questionnaire administered via structured face-to-face interviews assessed sociodemographic characteristics, clinical features including intercourse positions, penetration depth, and partner-related factors, and knowledge of pelvic floor therapy. Responses to 18 knowledge items were aggregated into a synthetic awareness variable (range 0–24 points). Internal consistency was evaluated using Cronbach’s alpha. Statistical analysis included item-level scoring, multiple linear regression, Mann–Whitney U test, Kruskal–Wallis test, and Spearman’s rank correlation. Effect sizes are reported as Cohen’s d for parametric comparisons and rank-biserial correlation for nonparametric comparisons. Results: The mean awareness score was 10.9 ± 6.1 out of 24 points. The awareness scale demonstrated good internal consistency (standardized Cronbach’s α = 0.880). Item-level analysis revealed critical knowledge gaps: biofeedback was recognized by only 15.3% of participants, and only 6.2% could correctly estimate the number of pelvic floor muscles. In multiple linear regression (R² = 0.224, adjusted R² = 0.153, p = 0.009), age (β = −0.305, p = 0.009) and current urogynecological physiotherapy use (β = 0.332, p = 0.019) were independent predictors of awareness. Physiotherapy users scored on average 5.6 points higher than non-users (16.0 ± 4.9 vs. 10.4 ± 6.0; p = 0.027; rank-biserial r = 0.51), although this finding should be interpreted with caution given the small number of physiotherapy users (n = 7) and the wide confidence interval. More than half of participants (55.6%) reported positional dependency of dyspareunia; in exploratory analyses, none of the assessed dyspareunia characteristics showed a statistically significant association with awareness. Younger women (≤24 years) demonstrated significantly higher awareness than older participants (12.1 ± 5.6 vs. 9.1 ± 6.5; p = 0.039; Cohen’s d = 0.51). Conclusions: Women with dyspareunia demonstrate modest and heterogeneous awareness of evidence-based treatments, with the largest deficits in knowledge of specific physiotherapeutic modalities. These findings highlight the need for targeted educational interventions and improved referral pathways to pelvic floor physiotherapy. This study establishes a conceptual framework for assessing patient awareness of dyspareunia treatments, which warrants validation in larger, multi-center studies. Full article

Background/Objectives: Urinary incontinence (UI) is a frequent condition in postmenopausal women and is associated with a substantial negative impact on quality of life. Conservative management can include pelvic floor muscle training (PFMT) and high-intensity focused electromagnetic stimulation (HIFEM); however, data regarding the potential benefit of combining these modalities remain limited. This study aimed to evaluate whether the addition of a structured Kegel exercise program to EMSELLA-based electromagnetic stimulation is associated with enhanced clinical outcomes in postmenopausal women with urinary incontinence. Methods: This prospective comparative study included 99 postmenopausal women with stress, urgency, or mixed urinary incontinence and an International Consultation on Incontinence Questionnaire–Urinary Incontinence Short Form (ICIQ-UI SF) score ≥ 6. Participants received either EMSELLA therapy alone (Group A, n = 49) or EMSELLA combined with a standardized Kegel exercise program (Group B, n = 50) over a three-month period. Symptom severity was assessed at baseline and at three months using the ICIQ-UI SF. Between-group comparisons were performed using analysis of covariance, adjusting for baseline scores. Results: Both therapeutic approaches were associated with clinically meaningful improvement in urinary incontinence symptoms. After adjustment for baseline severity, lower follow-up ICIQ-UI SF scores, greater mean symptom reduction, and higher response rates were observed in the combined-therapy group. Across all menopausal-duration subgroups, outcomes consistently favored the association of EMSELLA therapy with Kegel exercises. No treatment-related adverse events were reported. Conclusions: The association of EMSELLA electromagnetic stimulation with a structured Kegel exercise program was associated with greater symptom improvement than electromagnetic stimulation alone, suggesting an additive therapeutic effect of voluntary pelvic floor muscle training. This combined conservative approach was well tolerated and may represent a useful management strategy for postmenopausal urinary incontinence. Full article

Background/Objectives: This exploratory single-arm study evaluated the effects of non-ablative Erbium-doped Yttrium Aluminum Garnet (Er:YAG) laser therapy in a real-world healthcare setting. Methods: A prospective pre–post study was conducted in 47 postmenopausal women who received two sessions of non-ablative Er:YAG vaginal laser therapy (IncontiLase^®®/IntimaLase^®®). Assessments were performed at baseline and two follow-ups (FSFI, ICIQ-SF, I-QOL, and Oxford Scale). Wilcoxon signed-rank tests and Spearman correlations were used. Results: Vaginal hiatus was significantly reduced from 2.5 cm (IQR 2.0–3.0) to 2.0 cm (IQR 1.0–3.0) (p < 0.001). Vaginal length showed a small, non-significant increase, and pelvic floor strength was unchanged. Total FSFI scores remained stable; pain showed a non-significant upward trend, and arousal decreased transiently. ICIQ-SF scores did not significantly improve, although they correlated inversely with vulvar energy at second follow-up (r = −0.424; p = 0.016). I-QOL domains showed short-term improvements in social embarrassment (p = 0.002), psychosocial impact (p = 0.002), and behavioral limitations (p = 0.013) at first follow-up. Cystocele stage improved at second follow-up (p = 0.013). Conclusions: Non-ablative Er:YAG vaginal laser therapy was associated with reduced vaginal hiatus and produced short-term improvements in select quality-of-life domains and cystocele stage, while effects on sexual function and urinary symptoms were limited. Findings remain exploratory and inform the design of future controlled studies evaluating innovative outpatient care models for GSM. Given the absence of a control group and short follow-up, these findings should be interpreted as hypothesis-generating and may be influenced by placebo or expectation effects. Full article

Background/Objectives: Stress urinary incontinence (SUI) remains a common and functionally relevant complication after radical prostatectomy (RP) and substantially impairs quality of life (QoL). Although pelvic floor muscle training (PFMT) is guideline-recommended, its real-world effectiveness is often limited by accessibility, standardization, and adherence. Digital health interventions may improve adherence to PFMT, potentially influencing continence recovery. We conducted a multicenter randomized controlled trial to evaluate whether a structured, modular app-based PFMT program improves early continence recovery compared with conventional physiotherapist-guided training. Methods: Between September 2022 and September 2024, 62 preoperatively continent men undergoing radical prostatectomy were enrolled in this multicenter randomized controlled trial (Pelvintense). Both groups received perioperative PFMT: Patients were randomized 1:1 to either a modular app-based PFMT program (intervention group) or a standard physiotherapist-guided PFMT (control group). Both app-based PFMT and standard physiotherapist-guided PFMT started three weeks before surgery and continued for 90 days postoperatively. The primary endpoint was continence at 90 days, defined as ICIQ-SF Q1 = 0 (absence of involuntary SUI). Secondary endpoints included continence sub-scores, QoL, erectile function, adherence, and decision regret. Analyses were performed using a modified intention-to-treat approach applying logistic regression and non-parametric tests with sensitivity analyses. Results: A total of 62 patients were included in the study and randomized, with 31 allocated to the app-based PFMT arm and 31 to the standard physiotherapist-guided arm. Three patients in the control arm withdrew consent for data usage after randomization, resulting in a modified intention-to-treat population of 59 patients. At 90 days, continence rates were higher in the app-based group compared with the control group (74.2% versus 21.4%; p < 0.001), corresponding to an absolute risk reduction of 52.8% and a number needed to treat of two. In multivariable analysis, participation in the app-based program was independently associated with higher odds of continence recovery (odds ratio 13.80, 95%-confidence interval 3.22–59.12; p < 0.001). Continence at 30 days and continence-related QoL favored the intervention, whereas no significant differences were observed in erectile function at 90 days. Adherence to the PFMT was higher in the intervention group. Sensitivity analyses confirmed the robustness of the primary outcome. Conclusions: In this randomized controlled trial, a modular app-based PFMT program was associated with early continence recovery after prostatectomy compared with the standard-of-care physiotherapist-guided PFMT. Improved adherence, modular progression of exercises, and a more structured training delivery may have contributed to the effect. App-based PFMT might represent a scalable strategy to implement guideline-recommended supportive care. These findings warrant confirmation in studies with a longer follow-up. Full article

Background/Objectives: Non-ablative vaginal Erbium-doped Yttrium Aluminium Garnet (Er:YAG) laser therapy has been proposed as a minimally invasive option for pelvic floor dysfunction (PFD), yet objective anatomical data using standardized measures remain limited. This study evaluated short-term anatomical and functional outcomes in a real-world care setting. Methods: This prospective single-arm interventional cohort study included women with PFD who underwent two sessions of non-ablative vaginal Er:YAG laser therapy. Outcomes were assessed at baseline, first follow-up (FU1), and second follow-up (FU2). Anatomical changes were measured using POP-Q parameters, including vaginal hiatus (Gh), total vaginal length (TVL), and compartmental staging. Sexual function was evaluated using the Female Sexual Function Index (FSFI). Pelvic floor muscle strength was assessed using the Oxford Scale. Non-parametric tests were used for repeated measures, and correlations between delivered laser energy and clinical outcomes were explored. Results: A total of 163 women were enrolled; 136 completed FU1 and 59 completed FU2. Median vaginal hiatus decreased significantly from baseline to FU1 and remained reduced at FU2 (p < 0.001). Improvements in anterior and posterior prolapse staging were observed, with a shift toward lower POP-Q stages at both follow-up visits. FSFI total scores did not change significantly across visits, although small changes were observed in specific domains, including a transient decrease in orgasms at FU1 (Δ = −0.2, p = 0.021) and a modest improvement in pain at FU2 (Δ = −0.4, p = 0.045). The magnitude of anatomical changes was modest, and their clinical relevance remains uncertain. Conclusions: Non-ablative vaginal Er:YAG laser therapy was associated with short-term improvements in vaginal hiatus and POP-Q prolapse staging in women with PFD, while sexual function remained stable. These findings provide objective anatomical data on early treatment effects in routine care, informing future evaluation of minimally invasive care models for pelvic floor dysfunction. Full article

Objectives: This study aimed to investigate the impact of TDs on the survival of patients with locally advanced rectal cancer (LARC). Additionally, we propose a novel staging method that combines TDs and lymph node metastases (LNMs) to enhance prognostic accuracy. Methods: Patients with LARC were retrospectively identified from the Surveillance, Epidemiology, and End Results (SEER) database and a Sun Yat-sen University (SYSU) cohort. Propensity score matching (PSM) was utilized to minimize selection bias when evaluating TDs. We quantitatively stratified TDs counts and integrated them with regional LNMs to formulate a novel tumor node metastasis (TNM) staging system. Furthermore, a prognostic nomogram incorporating TDs was constructed and validated to predict survival. Results: Overall, 19,991 patients were included in the SEER database, with 2667 (13.3%) TDs-positive and 17,324 (86.7%) TDs-negative tumors. After PSM, multivariate Cox analysis reveals that TDs are an independent adverse prognostic factor (HR = 1.521, 95% CI: 1.366–1.693, p < 0.001). Patients with high-risk group (TDs > 4) at any TNM stage exhibit OS comparable to or worse than that of stage IIIC disease. For patients staged as T4N2M0, the high-risk group (TDs > 4) demonstrates OS equivalent to stage IV disease. The nomogram achieved C-indices of 0.713 (training cohort, n = 8586) and 0.789 (external validation cohort, n = 304), with AUCs of 0.774 (3-year) and 0.710 (5-year). Conclusions: The presence of TDs is associated with poorer OS, and integrating TDs with LNMs improves the accuracy of TNM staging. The nomogram (C-index = 0.789) provides enhanced prognostic stratification and survival prediction. Full article

Purpose: This study compared the therapeutic efficacy of different bladder monotherapies and multimodal therapy in patients with interstitial cystitis/bladder pain syndrome (IC/BPS). Materials and methods: In total, 190 patients with a confirmed diagnosis of IC/BPS were treated with different bladder therapies. The bladder monotherapies included intravesical platelet-rich plasma (PRP) injection (n = 60), intravesical botulinum toxin A (BoNT-A) injection (n = 33), intravesical hyaluronic acid (HA) instillation (n = 36), and low-energy shock wave (LESW) bladder therapy (n = 61). Multimodal therapy (MMT) was provided to patients who had unsuccessful initial bladder treatment targeting chronic inflammation, urothelial dysfunction, bladder pain, pelvic floor muscle pain, psychological stress, and lower urinary tract dysfunction. The treatment outcome was assessed using self-reported Global Response Assessment scores at 3 months and during the follow-up time points after bladder treatment. Results: Thirty-one patients received MMT. The 3-month success rates of bladder therapy were 55.0% for PRP injection, 57.6% for BoNT-A injection, 50.0% for HA instillation, 46.7% for LESW bladder therapy, and 58.1% for MMT. The success rates of bladder monotherapy decreased after 6 months. However, the success rate of MMT increased at 9 (67.7%) and 12 (73.1%) months. Patients treated with MMT exhibited improvement in glomerulation grade after cystoscopic hydrodistention. Only patients with successful treatment outcomes after MMT had improvement in bladder pain severity and pelvic floor muscle pain parameters. Conclusions: Bladder monotherapy such as PRP injection, BoNT-A injection, HA instillation, and LESW bladder therapy had successful treatment outcomes in patients with IC/BPS. In patients who had unsuccessful initial bladder therapy, the 3-month success rate of MMT was 58.1% and sustained improvement with time, particularly in the improvement of bladder pain and PFM pain severity. Full article

Chronic constipation (CC) is one of the most common disorders of gut–brain interaction, affecting more than 11% of adults in Western countries, with higher prevalence in women and in the elderly. Despite its significant impact on quality of life, most patients self-manage their symptoms, while only a minority seek medical attention from general practitioners (GPs) or specialists. Proper assessment not only often requires a multidimensional approach but also accurate diagnostic and therapeutic pathways that define the exact role of GPs and specialists. This paper describes a comprehensive Diagnostic–Therapeutic Care Pathway (DTCP) for CC, focusing on the full spectrum of diagnostic and therapeutic methodologies required for accurate patient assessment and management. The pathway involves a primary care physician intervention phase, responsible for first-line diagnostic and therapeutic management and evaluation using objective parameters, as well as reassessment at appropriate time points to identify patients requiring further specialist evaluation. Advanced diagnostic methodologies are described as being performed in specialized gastroenterology or neurogastroenterology settings. These include colonic transit studies with radiopaque markers, high-resolution anorectal manometry, balloon expulsion testing, magnetic resonance imaging or conventional defecography, ultrasonography, and neurophysiological assessments such as anal sphincter EMG and pudendal nerve latency testing. Full article

Background/Objectives: This study investigates the predictive role of pre-operative sonographic assessment of ovarian mobility in determining intra-operative ovarian resectability among patients undergoing vaginal hysterectomy for pelvic organ prolapse. Methods: This prospective study was conducted in a tertiary academic urogynecology center. Women with pelvic organ prolapse scheduled for vaginal hysterectomy were consecutively recruited after providing informed consent. Pre-operatively, all patients had a detailed history, pelvic examination (POP-Q), and pelvic floor ultrasound (including assessment of the mobility of both ovaries and sonographic determination of ovarian descent in relation to the pelvic ischial spines). Patients were planned for vaginal hysterectomy, anterior and posterior colporrhaphy, McCall culdoplasty, and bilateral salpingo-oophorectomy (SO), where feasible. During surgery, the location and mobility of the ovaries, as well as the presence of peri-ovarian adhesions, were recorded. Pair-to-pair comparisons between sonographic and clinical findings were performed. Results: From February 2023 to January 2024, 50 Caucasian adult women underwent reconstructive vaginal surgery for prolapse. Thirty-five patients underwent concomitant bilateral SO via vaginal route, seven underwent unilateral SO, and three under went salpingectomy only. ROC analysis indicated that pre-operative ultrasound assessment of ovarian mobility predicts: (1) intra-operative ovarian mobility (sensitivity 95.6%, specificity 77.8%); (2) the presence of peri-ovarian adhesions (sensitivity 46.1%, specificity 94.2%); and (3) resectability, i.e., the ability to perform SO via the vaginal route (sensitivity 96.4%, specificity 50.0%). The absence of ovarian mobility was not associated with an increased risk of intra-operative and post-operative complications. Conclusions: Pre-operative sonographic assessment of ovarian location and mobility can predict ovarian location and resectability during vaginal surgery with high diagnostic accuracy. Full article

Background/Objectives: This randomized controlled trial aimed to investigate the effects of stabilization exercises combined with pelvic floor muscle training (PFMT) on urinary parameters in individuals with chronic low back pain (CLBP) and urinary incontinence. Methods: A total of 44 women aged 18–65 years were randomized into three groups: PFMT combined with stabilization exercises, standard PFMT group, and a control group. The intervention groups participated in an 8-week exercise program. Urinary symptoms, anxiety, and quality of life were assessed using validated questionnaires. Results: The primary outcome (UDI) demonstrated significantly greater improvement in the PFMT combined with stabilization group compared with both the standard PFMT and control groups (p < 0.01). Post-treatment comparisons indicated that both intervention groups showed significant improvements in urinary symptoms and quality of life compared with the control group (p < 0.05). Conclusions: PFMT combined with stabilization exercises may be an effective approach for improving urinary parameters. Further studies are warranted to better elucidate the efficacy of PFMT combined with stabilization exercises. Trial Registration: ClinicalTrials.gov Identifier: NCT05666427. Full article

Background and Objectives: Pregnancy and the postpartum period profoundly affect female sexual function, yet longitudinal data integrating obstetric and psychosocial domains are scarce. We aimed to chart sexual-function trajectories from early pregnancy to 12 months postpartum and identify predictors of persistent dysfunction. Materials and Methods: In this single-center prospective cohort, 187 pregnant women were eligible to complete the FSFI at three trimesters and at 6–8 weeks, 3 months, and 6–12 months postpartum, plus postpartum PHQ-9, WHOQOL-BREF, and body-image scales. Associations with FSFI-defined dysfunction (FSFI < 26.55) and continuous FSFI were examined, of which 90 women were included for having documented dysfunction. Results: Mean FSFI declined from 27.4 ± 3.9 (first trimester) to a nadir of 20.1 ± 4.2 at 6–8 weeks postpartum, with partial recovery to 25.5 ± 4.0 at 6–12 months (p < 0.001). Depressive symptoms were higher in women with dysfunction (PHQ-9 8.8 ± 3.3 vs. 6.7 ± 3.5; p < 0.001) and correlated inversely with FSFI (r = −0.39; p < 0.001). A multivariable model explained 19% of FSFI variance, with each 1 SD PHQ-9 increase predicting a 1.2-point FSFI decrease (p = 0.005). Body-image disturbance exerted a partially PHQ-9-mediated effect, and three FSFI trajectory clusters showed postpartum dysfunction rates from 28.6% to 89.7%. A combined psychosocial prediction model achieved an AUC of 0.9 with a sensitivity and specificity of 0.8. Conclusions: Postpartum sexual dysfunction was common and persisted in many women at one year; depressive symptoms, body image, and psychological quality of life were more influential than mode of birth, breastfeeding, or pelvic-floor symptoms. Full article

Background/Objectives: Solitary rectal ulcer syndrome (SRUS) is a rare benign disorder presenting with rectal bleeding, straining, and mucosal discharge. Its pathogenesis likely involves pelvic floor dysfunction, particularly dyssynergic defecation. Although studied in adults, pediatric data—specifically anorectal manometry (ARM) findings—remain limited. We aimed to evaluate dyssynergic defecation in pediatric SRUS using ARM and analyze associated clinical, endoscopic, histopathological, and treatment data. Methods: A retrospective study of 24 children with biopsy-proven SRUS diagnosed between 2016 and 2024 was conducted. Clinical symptoms, colonoscopic, histopathological, treatment, and outcome data were reviewed. ARM was performed in 20 patients unresponsive to conservative treatment to assess anal pressures, rectal sensation, rectoanal inhibitory reflex, and balloon expulsion. Results: The median age was 13 years, with male predominance. Rectal bleeding was the most common symptom (95.8%). Colonoscopy revealed predominantly solitary ulcerative lesions 5–10 cm from the anal verge. Dyssynergic defecation was detected in 60% of patients, and only 25% could expel the balloon. Resting anal pressures were lower than reference values. Treatments included diet, laxatives, and topical agents, with partial or complete clinical response in approximately 60% of patients after 12 months. Conclusions: Pediatric SRUS is strongly associated with dyssynergic defecation. More pediatric-specific manometric studies are needed to optimize diagnosis and guide targeted therapies. Full article

Background/Objectives: Pelvic floor disorders (PFDs), which include pelvic organ prolapse and urinary incontinence, are common conditions that often affect sexual health, but remain under-assessed within routine care. The following cases are presented to demonstrate the potential of a brief sexual health questionnaire in pelvic floor clinics and to explore how sexual function varies across common PFD phenotypes. Methods: A pilot case series was conducted with a group of five sexually active women diagnosed with PFDs at the Materno-Infantil University Hospital in Gran Canaria, Spain, between January and December 2025. Patients completed the Female Sexual Function Index (FSFI) at the index visit. Results: Mean age was 40.6 years (range 35–46), mean parity was 1.6 births and 60% were active smokers. Mean FSFI total score was 26.9 (range 21.4–32.2) and 60% scored below 26.55. Desire and arousal were relatively preserved (means 5.0 and 4.9), whereas lubrication (3.4) and satisfaction (3.9) showed greater variability. Pain scores were low overall (mean 5.2). Self-rated sexual satisfaction was low in 40%, moderate in 40% and high in 20%. Moderate-to-high anticipatory sexual anxiety was present in 80%. Conclusions: Integrating a concise questionnaire based on the FSFI into the pelvic floor consultation appears to be a reasonable approach, with the potential to address secondary sexual dysfunction in patients with PFD, thereby facilitating personalised counselling and treatment. Full article

Background: The BEST study investigated the effectiveness of a 12-week digital treatment program for male LUTS. Here, we report on the long-term outcomes of the patients involved in this trial. Methods: The randomized controlled BEST trial enrolled 237 patients (intervention group, IG: n = 112, hereafter referred to as the direct intervention group [DIG]; control group, CG: n = 125, hereafter referred to as the postponed intervention group [PIG]). The intervention consisted of pelvic floor muscle training, behavioral training, completion of a micturition diary, bladder training, urge suppression techniques, fluid and dietary management, and structured educational content. Patients in the DIG received the intervention immediately, Patients in the PIG after a 12-week waiting period. Patients in both groups were offered the option to complete additional treatment cycles at their discretion. The primary endpoint was change from baseline in the International Prostate Symptom Score (IPSS). Secondary endpoints included the symptom severity (OAB-q SF1) and quality-of-life (OAB-q SF2) subscales of the Overactive Bladder Questionnaire, among others. Long-term follow-up assessments at 24, 36, and 48 weeks for participants in both study arms were prospectively specified in the study protocol. Results: Baseline data from 236 patients were available for the follow-up analyses. In a linear mixed-effects model, the fixed effect of time on IPSS was found to be statistically significant (F(4, 515.245) = 89.77, p < 0.001), indicating differences across measurement time points. Compared with the baseline, IPSS scores were lower at all subsequent follow-up assessments. The mean difference between the baseline and 12 weeks after was −6.32 points (95% CI: −7.60 to −5.04; p < 0.001). Differences between the baseline and 24 weeks (−7.81 points; 95% CI: −9.37 to −6.25; p < 0.001), baseline and 36 weeks (−8.62 points; 95% CI: −10.46 to −6.79; p < 0.001), and baseline and 48 weeks (−9.56 points; 95% CI: −12.66 to −6.46; p < 0.001) were also statistically significant. Comparable patterns of improvement were observed for both subscales of the OAB-q Short Form questionnaire. In a separate linear mixed-effects model, the fixed effect of time on IPSS after the discontinuation of app usage was not statistically significant (F(2, 19.750) = 0.01, p = 0.992), suggesting stable effects after discontinuation. Conclusions: Long-term outcomes of the structured app-based therapeutic program demonstrated that a multimodal digital intervention for male LUTS induces a rapid and clinically meaningful symptom reduction within the first 12 weeks, with consolidating and sustaining benefits over up to 48 weeks. Full article

Additive manufacturing (AM) offers new opportunities for biomedical device design; however, its translation to soft-tissue reinforcement remains challenging, particularly in pelvic organ prolapse (POP) applications requiring mechanical performance and tissue compatibility. In this study, a hybrid AM approach combining melt electrowriting (MEW) and controlled post-processing was developed to fabricate biodegradable poly(ε-caprolactone) (PCL) cog threads for minimally invasive pelvic reinforcement. This integrated fabrication workflow enables the precise deposition of microscale fibers via MEW followed by localized mechanical modification, offering a versatile platform for tailoring graft architecture and anchoring geometry. Smooth filaments were first produced via MEW and subsequently post-processed to introduce barbs for mechanical anchorage. The resulting structures were mechanically characterized through uniaxial tensile testing and evaluated as reinforcement elements in ex vivo sow vaginal tissue using ball burst testing. The MEW-fabricated cog threads increased the ultimate load of vaginal tissue from 83 ± 20 N (control) to 126 ± 15 N, corresponding to a 51.8% improvement (p = 0.0477). Compared with commercial PCL cog threads reported in the literature (177.0 ± 5.4 N), the reinforced specimens achieved approximately 71% of the benchmark load. Owing to their intermediate stiffness profile, the MEW-fabricated cog threads reduced mechanical mismatch with soft tissue compared to high-stiffness commercial alternatives. These findings demonstrate the feasibility of hybrid MEW-based additive manufacturing strategies for engineering mechanically compatible, application-driven soft-tissue reinforcement systems. Full article