Chapter 4.5: New Proposed Treatments for Pelvic Organ Prolapse

Pelvic organ prolapse (POP) is a morbid and costly condition that affects millions of women worldwide. Given the shortcommings of the current treatments, novel preventative and therapeutic approaches are needed. This manuscript is part of the International Urogynaecologogy Consultation (IUC) on pelvic organ prolapse (POP) chapter four on new and novel treatments for pelvic organ prolapse. The current expert narrative review (1) highlights the rationale for novel treatments for POP; (2) summarizes the exisitng mechanistic insights into physiologic alterations needed to inform the development of novel preventative and therapeutic strategies for POP; (3) reviews relevant modern tools that can help establish causal relationships between epidemiologic risk factors and POP pathogenesis; (4) describes prevention-focused interventions and advancements in treatment-focused interventions to date; and (4) emphasizes requirements for responsible translation of discoveries into novel treatments and safe incorporation of new treatments into clinical practice. Importantly, the review underscores the need for multidisciplinary adequately funded research and training programs as an absolute prerequisite for enabling a long overdue shift in clinical paradigm-instead of relying on delayed compensatory "one-size-fits-all" treatments that do not address the underlying pathophysiology, the focus should be on preventing or mitigating POP through personalized medicine approaches supported by team science.