OPTIMIZATION OF THE PREOPERATIVE MODELING STRATEGY AND PERSONALIZED SELECTION OF SURGICAL TREATMENT FOR PELVIC FLOOR DYSPLASIA IN FERTILE PATIENTS

The study aimed to optimize preoperative modeling and the individualized selection of surgical treatment for genital prolapse in women of childbearing age.Materials and methods: A retrospective-prospective descriptive comparative analysis of clinical and functional data from 85 fertile women (Group 1: n=45 with connective tissue dysplasia markers; Group 2: n=40 without manifest CTD) was conducted. Anatomical defects were quantified using the international POP-Q system, levator muscle tone was evaluated via perineometry and 3D/4D pelvic floor ultrasound, and systemic connective tissue dysplasia was assessed using clinical risk scores.Results: Standardized objective quantification using POP-Q, integration of obstetric history, levator defect scoring, and metabolic/CTD markers allowed for the development of a predictive mathematical risk matrix. Custom laparoscopic reconstructive techniques (pectopexy and laparoscopic sacrocolpopexy with autologous/mesh organ-preserving repair) yielded 95.6% 2-year anatomical success compared to 77.5% in standard vaginal repair.Conclusion: Personalized surgical strategies and preoperative modeling based on multiple functional, anatomic, and connective tissue parameters significantly improve long-term outcomes, preserve reproductive capacity, and minimize recurrence in fertile women with pelvic floor dysplasia