Clinical phenotypes of pelvic organ prolapse: setting priorities

Pelvic organ prolapse (POP) is a prolapse of the pelvic organs as a result of a weakening of the pelvic floor supporting system. To denote prolapse of the anterior vaginal wall, the term «cystocele» is used, of the posterior wall — «rectocele», while the lowering of the arch / stump of the vagina or cervix is called «apical prolapse». There is also a «total prolapse» — a recurrence of the pathological process with all three sectors involved, and the uterus extending beyond the genital fissure. The genitals involved in the pathological process determine the POP clinical picture; 2/3 of women show signs of two or three sectors involved in the process at the same time. In general, surgical procedures are effective in relieving the POP symptoms, preventing the disease progression and improving quality of life. However, the short- and medium-term results of surgical treatment are not always satisfactory. The recurrence rate of POP after surgical treatment is high, and the need for repeated surgery is approaching 30%. The purpose is to analyze and summarize the current scientific data on the POP clinical phenotypes. We analyzed 2014–2024 scientific publications in the PubMed, eLibrary, CochraneLibrary, and Science Direct databases using the keywords: pelvic organ prolapse, cystocele, rectocele, and apical prolapse. Conclusions. Based on the literature analysis, we conclude that to date there is no understanding of the mechanics of the POP formation in different parts of the pelvis, the interaction of prolapses of the contralateral sections. There is no unified approach among specialists to the treatment of patients with POP, and indications for surgical intervention are not unified. This determines the importance of studying different clinical phenotypes of POP, their relationship and interaction in a large sample.