Improved healing and tissue regeneration for prevention and treatment of pelvic floor disorders: from reactive treatment to proactive prevention

Vollständiger Abstract

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Pelvic floor disorders (PFDs), including pelvic organ prolapse (POP), stress urinary incontinence (SUI), and obstetric fistula, impose a major global health burden. Largely driven by birth-related trauma, they reduce quality of life and can cause physical, psychological, and social consequences. Current surgical and conservative treatments often fail to address underlying tissue damage and impaired healing, contributing to high recurrence; up to 30% of patients require repeat procedures. Tissue engineering and regenerative medicine offer promising alternatives by targeting damaged pelvic tissues and promoting repair and regeneration. Enhanced healing strategies can potentially prevent PFD development by strengthening pelvic floor tissues during critical periods of vulnerability, such as pregnancy and childbirth, while also improving outcomes following injury or surgical intervention. This paradigm shift from reactive treatment to proactive prevention and biological restoration represents a transformative opportunity in PFD management. This review examines the current landscape of tissue regeneration strategies for PFDs. We explore emerging therapeutic approaches within the tissue engineering framework, including biofunctional materials, cell-based therapies, bioactive molecules, molecular interventions, and external stimulations designed to promote native tissue regeneration. This review provides an overview of impaired healing mechanisms in pelvic floor tissues and evaluate how targeted regenerative interventions address these deficiencies. We examine the clinical implications of regenerative strategies in PFD management, including reduced surgical burden, improved outcomes, and preventive interventions. Emphasis is placed on their translational potential from bench to bedside, to inform clinicians and researchers about innovative approaches that may fundamentally transform the prevention and treatment of pelvic floor disorders.