Abstract
To evaluate the anatomical outcomes of transobturator tension-free sling combined with posterior pelvic reconstruction in patients with stress urinary incontinence and pelvic organ prolapse using high-resolution magnetic resonance imaging. This study included 50 women with stage II POP and SUI who underwent the combined surgery, along with 10 matched healthy controls. Preoperative and postoperative pelvic floor morphology was assessed via MRI, measuring parameters including perineal body area, urethral length, levator hiatus dimensions, vaginal angles, and spatial coordinates of key anatomical landmarks. Postoperative MRI demonstrated significant restoration of pelvic floor anatomy: perineal body area increased (572.84 ± 90.42 mm² vs. preoperative 306.24 ± 90.33 mm², P < 0.001), urethral length extended (37.89 ± 4.70 mm vs. 31.58 ± 4.12 mm, P < 0.001), and levator hiatus parameters normalized. Vaginal axial deviations and landmark coordinates were effectively corrected, showing statistical improvement compared to preoperative values (P < 0.05) and restoration to levels comparable with controls. The TOT combined with posterior pelvic reconstruction effectively restores pelvic floor anatomy and biomechanical balance, providing an objective imaging basis for the anatomical restoration achieved by this procedure in treating SUI with POP.
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Data availability
The datasets analyzed during the current study are available from the corresponding author on reasonable request.
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Funding
This study was supported by the “Xingdian Talents” Support Project of Yunnan Province: No. RL2024SJH; National Natural Science Foundation of China: No. 82260297; Yunnan Provincial Key Research and Development (R&D) Program: No. 202502AA310034.
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Conceptualization: D.T. and L.L.; methodology: D.T., Q.L.and L.L.; data collection,:X.W., Y.W., Y.L., J.G., H.L. and J.S.; writing—original draft preparation: D.T. and Q.L.; writing—review and editing: L.L.; supervision: L.L. All authors have read and agreed to the published version of the manuscript.
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The study was conducted in accordance with the Declaration of Helsinki and approved by Institutional Review Board of The First Affiliated Hospital of Kunming Medical University [IRB No. (2022) Ethical Review L No. 332022.04.27].
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Tian, D., Luo, Q., Wang, X. et al. Multiparametric comparative assessment of surgical efficacy in patients with SUI and POP versus normal controls. Sci Rep (2026). https://doi.org/10.1038/s41598-026-35587-2
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DOI: https://doi.org/10.1038/s41598-026-35587-2
