Robotic Surgery for the Treatment of Apical Pelvic Organ Prolapse at a Single Institution

Objective: We sought to present implementation of robotic surgery for the treatment of apical pelvic organ prolapse at our clinic, with short-term outcomes.Study design: Clinical data of 11 consecutive patients with apical pelvic organ prolapse, who underwent robotic sacrocolpopexy or hysteropexy between July 2015 and August 2016, were collected prospectively. Primary endpoint of the study was anatomic cure and the secondary endpoint was symptomatic cure. Anatomic cure was defined as lack of anterior or posterior prolapse beyond the hymen and apical prolapse beyond the midvagina. Symptomatic cure was lack of vaginal bulge sensation.Results: Of the 11 patients, 9 underwent sacrocolpopexy and two underwent hysteropexy. Sacrocolpopexy was performed concomitantly with hysterectomy in 7 of the 9 patients. Mean operating time for all procedures was 254±65 minutes. No conversion to open surgery was required and no intraoperative complication was observed in any of the patients. The median hospital stay was 3 days. Four complications occurred postoperatively: 1 case of pulmonary thromboembolism, 2 cases of vaginal vault cellulitis and 1 case of mesh erosion. In total, 10 of 11 patients (90.9%) met the criteria for anatomic and symptomatic cure. Conclusion: Robotic pelvic support procedures can be readily adopted to routine clinical practice with high anatomic and symptomatic cure rates.

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Patients’ Knowledge of and Attitude Toward Robotic Surgery for Pelvic Organ Prolapse

Female Pelvic Medicine & Reconstructive Surgery ◽

10.1097/spv.0000000000000556 ◽

2019 ◽

Vol 25 (4) ◽

pp. 279-283 ◽

Cited By ~ 4

Author(s):

Christine M. Chu ◽

Anubhav Agrawal ◽

Donna Mazloomdoost ◽

Benjamin Barenberg ◽

Tanaka J. Dune ◽

...

Keyword(s):

Pelvic Organ Prolapse ◽

Robotic Surgery ◽

Pelvic Organ

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Robotic sacrocolpopexy for the management of pelvic organ prolapse: quality of life outcomes

Therapeutic Advances in Urology ◽

10.1177/1756287219868593 ◽

2019 ◽

Vol 11 ◽

pp. 175628721986859

Author(s):

Annah Vollstedt ◽

William Meeks ◽

Veronica Triaca

Keyword(s):

Quality Of Life ◽

Pelvic Organ Prolapse ◽

Pelvic Floor ◽

Clinical Improvement ◽

Pelvic Organ ◽

Robotic Sacrocolpopexy ◽

Robotic Assisted ◽

Rectocele Repair ◽

Bowel Symptoms

Background: Our aim was to investigate longer-term surgical and quality of life (QOL) outcomes in a cohort of women undergoing robotic-assisted laparoscopic sacrocolpopexy (RALS) for pelvic organ prolapse (POP). Methods: We performed a retrospective cohort study at a single institution of female patients undergoing RALS with and without concomitant robotic-assisted laparoscopic hysterectomy, urethral sling, and rectocele repair. Scores from the Pelvic Floor Distress Inventory (PFDI) and Pelvic Floor Impact Questionnaire (PFIQ) surveys were used to evaluate QOL outcomes. Clinical improvement was defined by a decrease in a patient’s PFDI and PFIQ postoperative score by ⩾70%. Results: Clinical improvement was seen in 62.6% by the PFIQ and in 64% by the PFDI survey. Younger patient age (OR 0.92, p = 0.011) and worse preoperative American Urological Association (AUA) Quality of Life score (OR 1.42, p = 0.046) were associated with clinical improvement. Within the PFIQ, 35.6% of patients saw clinical improvement with their bowel symptoms, compared with bladder (54.1%, p < 0.001) and prolapse (45.6%, p = 0.053) symptoms. Within the PFDI, 45.5% of patients reached clinical improvement with their bowel symptoms, compared with bladder (56.7%, p = 0.035) and prolapse (62.6%, p < 0.001) symptoms. Of the patients who had a rectocele repair, 46.3% reached clinical improvement in their CRADI-8 score, and 51% saw clinical improvement in the bowel portion of the PDFI. Conclusions: Significantly fewer patients reached clinical improvement within the portions of the surveys that focus on bowel symptoms, compared with symptoms related to urination and POP. Of those that had a concomitant rectocele repair, approximately half reached clinical improvement with their bowel symptoms.

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