Development of a personalized algorithm for managing women with pelvic organ prolapse and associated gynecologic conditions
Жамбас ағзаларының пролапсы және қатар жүретін гинекологиялық патологиясы бар әйелдерді емдеудің дербестендірілген алгоритмін әзірлеу
Разработка персонализированного алгоритма ведения женщин с пролапсом тазовых органов и сопутствующей гинекологической патологией
Meirmanova A.O. Omarova G.K. Buzumova Z.O. Begniyazova Z.S. Makhmutova E.A. Bazarbayeva Z.U.
30 December 2025Kaz Med Print LLP
Reproductive Medicine (Central Asia)
2025#2025Issue 4
Relevance: Pelvic organ prolapse (POP) is one of the most frequent pelvic floor disorders among peri- and postmenopausal women, leading to progressive descent of pelvic structures, discomfort, urinary and sexual dysfunction, and a decline in overall quality of life (QoL). POP remains a major cause of morbidity in this population. The previous study compared the outcomes of various surgical methods for prolapse correction in middle-aged and older women for developing a personalized algorithm. This paper extends the research by focusing on the development and validation of a personalized clinical algorithm designed to optimize surgical decision-making and improve long-term outcomes. This study aimed to design and validate a clinical algorithm for personalized management of women with pelvic organ prolapse and concomitant gynecologic pathology to reduce recurrence and improve the outcomes and quality of life. Materials and Methods: This retrospective-prospective observational study included 195 women aged 45-70 years with POP who underwent a clinical examination, POP-Q staging, ultrasound, MRI, and laboratory tests. The main group (n = 137) underwent laparoscopic-assisted vaginal hysterectomy (LAVH), and the control group (n = 58) received conventional vaginal hysterectomy (VH). Surgical correction was combined with the removal of associated gynecologic conditions and pelvic floor reconstruction. QoL was assessed using the P-QOL and ICIQ-VS questionnaires. Statistical analysis was performed using IBM SPSS Statistics v25. Results: Surgical management significantly improved both anatomical and functional outcomes. Six months after surgery, complete pelvic floor restoration was achieved in 96.35% of LAVH and 89.66% of VH patients (p = 0.064). Excellent self-assessed results were reported by 53.5% of LAVH and 28.9% of VH patients. The recurrence rate was 0.73% and 5.17%, respectively. Conclusion: Introduction of a personalized surgical approach integrating laparoscopic-assisted methods with structured quality-of-life assessment enhances treatment effectiveness, minimizes recurrence, and promotes physical and psychosocial recovery in women with POP.
gynecologic pathology , individualized approach , laparoscopic-assisted vaginal hysterectomy , pelvic organ prolapse (POP) , quality of life (QoL) , recurrence , women’s health
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Kazakhstan Medical University “Higher School of Public Health”, Almaty, Kazakhstan
Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
Kazakhstan Medical University “Higher School of Public Health”
Asfendiyarov Kazakh National Medical University
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