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ArticleInternational urogynecology journal2026

Proposed Innovation Ecosystem for Prolapse Surgery: Delphi Consensus on Roles and Responsibilities Across Innovation Lifecycle.

Geoffrey W Cundiff, Alex Almendres, Mickey Karram, Okhumhekho Kassim, Karen Noblett, Cindy Mayer

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Article in International urogynecology journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Geoffrey W CundiffUniversity of British Columbia School of Medicine, 354 Tempe Cres, North Vancouver, BC, V7N 1E6, Canada. geoff.cundiff@ubc.ca.ORCID http://orcid.org/0000-0002-5777-7836
Alex AlmendresNeomedical International, Barcelona, Spain.
Mickey KarramSchool of Medicine, University of Cincinnati, Cincinnati, OH, USA.
Okhumhekho KassimColoplast Women's Health Program, Minneapolis, MN, USA.
Karen NoblettAVeta Medical, Orange County, CA, USA.
Cindy Mayer, Patient representative, Ponce Inlet, FL, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introduction and hypothesisSurgical management of primary uterovaginal prolapse is undergoing rapid transformation, driven by novel devices, meshes, minimally invasive approaches, and digital tools. Yet the legacy of transvaginal mesh, device withdrawals, and litigation has exposed major gaps in how new prolapse technologies are conceived, evaluated, adopted, and monitored. We hypothesize an ecosystem that defines optimal roles and interactions among key parties in the innovation ecosystem for surgical management of primary uterovaginal POP.

methodsWe conducted a Delphi consensus study with patients, clinicians, academics, and industry representatives to define optimal roles and interactions across the innovation continuum-from concept generation through post market surveillance. We identified seven separate domains of healthcare innovation and preformed literature searches for each based on a PICOTS framework. This informed an iterative process to develop the sequential rounds of the Delphi survey.

resultsThe panel achieved consensus on patient centered needs finding, staged and transparent evaluation aligned with the IDEAL framework, competency based training and credentialing, and continuous, socially responsible post market surveillance supported by high quality registries. There was also consensus on priorities for innovation, including identifying predictors of recurrent POP and developing training techniques to overcome perceived barriers to vaginal surgery.

conclusionsThis commentary synthesizes the resulting concepts into a framework that could help rebuild trust and support safer, more effective innovation.

Indexed as

Delphi consensusMedical devicesPelvic organ prolapsePost-market surveillanceSurgical innovation

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.