To evaluate the efficacy and safety of total pelvic floor reconstruction centered on modified laparoscopic pectopexy (MLP), designated as "Chaoyang-Chen Total Pelvic Floor Reconstruction" (Chen's procedure for short), in the treatment of pelvic organ prolapse (POP).

This was a single-center retrospective cohort study. A retrospective analysis was performed on 189 patients who underwent Chen's procedure at Beijing Chaoyang Hospital between March 2020 and December 2024. The procedure utilized the self-designed "Chaoyang mesh" and combined pectopexy with uterosacral ligament suspension, round ligament shortening, and anterior and posterior vaginal wall repair. Anatomical outcomes were assessed using the Pelvic Organ Prolapse Quantification (POP-Q) system before and after the surgery. Symptom severity and quality of life were evaluated using the Pelvic Floor Distress Inventory-20 (PFDI-20) and the Pelvic Floor Impact Questionnaire-7 (PFIQ-7).

After the surgery, all POP-Q measurement points (Aa, Ba, Ap, Bp, C, and D) were significantly elevated compared with preoperative values, and all were restored to above the hymenal level. Satisfactory anatomical and functional repair was achieved in all patients. The preoperative-to-postoperative differences in Aa, Ba, C, Ap, Bp, and D were 3.50 (2.00, 5.00), 5.00 (2.50, 6.00), 8.00 (6.00, 10.00), 2.00 (1.50, 3.50), 3.50 (2.00, 5.00), and 7.00 (5.50, 9.50), respectively, with statistically significant differences (Z=-11.57, -11.74, -11.92, -11.68, -11.81, -11.54; all P<0.001). Postoperative PFDI-20 and PFIQ-7 scores were significantly lower than preoperative scores, with differences of 128.13 (87.50, 168.75) and 152.38 (104.76, 188.10), respectively. The differences were statistically significant (Z=-11.92, -11.92; both P<0.001). No severe perioperative complications occurred. New-onset stress urinary incontinence occurred in 1 patient, abnormal urination in 1 patient, and deep vein thrombosis of lower extremities in 8 patients. Follow-up ranged from 12 to 60 months. No recurrence was observed during follow-up period.

Chen's procedure provides reliable short- and mid-term efficacy with favorable safety in patients with POP.