UROGYNECOLOGICAL SURGERY CURRENT APPROACHES AND TREATMENTS FOR INCONTINENCE

Urogynecological_Surgery_Kapak

PERSONALIZED UROGYNECOLOGICAL STRATEGIES AND PATIENT-CENTRIC SURGICAL SELECTION

Gizem Boz İzceyhan

University of Health Science, Zeynep Kamı̇l Women and Children Dı̇ seases Tranı̇ng and Research Hospital, Department of Gynecology and Obstetrics, İstanbul, Türkiye

Boz İzceyhan G. Personalized Urogynecological Strategies and Patient-Centric Surgical Selection. In: Balsak D, Çim N, Ege S editors. Urogynecological Surgery Current Approaches and Treatments for Incontinence. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.359-364.

ABSTRACT

Pelvic floor disorders are complex conditions that profoundly affect women?s quality of life, with surgical interventions often serving as primary therapeutic options. In common disorders such as pelvic organ prolapse (POP) and stress urinary incontinence (SUI), treatment success should not be defined solely by anatomical correction but also by the extent to which individual goals, quality of life, and patient satisfaction are achieved. Recent years have witnessed a paradigm shift toward patient-centered approaches, particularly the adoption of shared decision-making (SDM), which has become an essential component of contemporary urogynecological practice. This model facilitates patients? understanding of treatment options, clarifies their preferences, and strengthens physician-patient collaboration. The literature provides robust evidence that the use of decision-support tools enhances patient satisfaction, improves comprehension, and increases adherence to treatment plans. Surgical decision-making should carefully integrate individual factors such as age, comorbidities, fertility desires, sexual activity, and prior surgical history. Furthermore, uterus-preserving techniques, minimally invasive approaches, and strategies that align with patient expectations represent critical determinants of clinical success. Long-term follow-up emphasizes that success should be assessed not merely by recurrence or anatomical outcomes but also through quality-of-life measures and the degree to which personal goals are achieved. Instruments such as the Pelvic Floor Distress Inventory (PFDI-20), Pelvic Floor Impact Questionnaire (PFIQ-7), Incontinence Impact Questionnaire (IIQ), and Goal Attainment Scaling (GAS) provide structured frameworks for evaluating these outcomes. Collectively, these findings underscore that individualized surgical planning, rooted in holistic and patient-centered principles, significantly enhances therapeutic efficacy and long-term patient satisfaction. Such approaches highlight not only the ethical necessity of incorporating patient values into surgical decision-making but also the clinical advantage of achieving superior outcomes. Ultimately, integrating patient-defined success metrics, functional improvements, and psychosocial benefits into surgical algorithms?supported by multidisciplinary collaboration?offers a comprehensive strategy that elevates the quality and effectiveness of urogynecological care.

Keywords: Precision medicine; Patient participation; Quality of life

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