Long-term follow-up and quality of life after robot assisted sacrohysteropexy

Grimminck, K.; Mourik, Sarah L.; Tjin-Asjoe, F.; Martens, Jolise E.; Aktaş, Mustafa Sinan

doi:10.1016/j.ejogrb.2016.06.027

Cited by 14 publications

(6 citation statements)

References 21 publications

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“…Improvement of sexual function as well as disease-related quality of life after sacrocolpopexy has also been demonstrated in some studies (Grimminck et al, 2016;Ko et al, 2017). Tahaoglu et al (2018) reported significant improvement in quality of life and sexual function after laparoscopic pectopexy.…”

Section: Discussionmentioning

confidence: 70%

Laparoscopic Pectopexy: An Effective Procedure for Pelvic Organ Prolapse with an Evident Improvement on Quality of Life

Karslı

Kale

2021

Prague Med. Rep.

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It has been stated that the effectiveness of pectopexy method for the treatment of pelvic organ prolapse (POP) is similar to sacrocolpopexy. We aimed to search the effects of pectopexy method to the quality of life, sexual function and urinary incontinence. Thirty-one patients who were operated for POP with the technique of laparoscopic pectouteropexy/pectocolpopexy between January 2016 and November 2017 were included the study. Exclusion criteria were pelvic inflammatory disease, suspect of malignancy, pregnancy, prior POP or continence surgery. Quality of life inventories were (P-QOL, PISQ-12, UDI-6, IIQ-7) recorded preoperatively and at the postoperative third month. Results were compared statistically. The percentage of patients with menopause was 67.7% (n=21) and with reproductive term was 32.3% (n=10). Mean prolapse related quality of life inventory (P-QOL) score was 83.45 ± 8.7 (64–98) preoperatively and 8.61 ± 6.4 (0–23) postoperatively (p<0.05). The preoperative and postoperative score of quality of life inventories for urinary symptoms were 20 (15–21) and 2 (0–9) for IIQ-7 and 13 (3–18) and 4 (0–11) for UDI-6, respectively (p<0.05). The mean PISQ-12 sexual quality of life inventory score was 29.61 ± 4.8 (14–38) preoperatively and 7.1 ± 3.2 (1–13) postoperatively. According to our results laparoscopic pectopexy offers a feasible, safe and comfortable alternative for apical prolapse surgery.

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Section: Discussionmentioning

confidence: 70%

Laparoscopic Pectopexy: An Effective Procedure for Pelvic Organ Prolapse with an Evident Improvement on Quality of Life

Karslı

Kale

2021

Prague Med. Rep.

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“…Comparison of our findings with the literature for sacrohysteropexy is difficult owing to the heterogeneity of reporting mesh complications. Long-term cohort studies have reported mesh erosion rates of 4% following robotics-assisted sacrohysteropexy, and 5% following open sacrohysteropexy, with no details regarding reoperation [ 28 , 29 ]. A variety of surgical techniques exist for sacrohysteropexy, with no clear evidence to support one particular approach over another.…”

Section: Discussionmentioning

confidence: 99%

Long-term mesh complications and reoperation after laparoscopic mesh sacrohysteropexy: a cross-sectional study

et al. 2020

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Introduction and hypothesis The paucity of long-term safety and efficacy data to support laparoscopic mesh sacrohysteropexy is noteworthy given concerns about the use of polypropylene mesh in pelvic floor surgery. This study is aimed at determining the incidence of mesh-associated complications and reoperation following this procedure. Methods This was a cross-sectional postal questionnaire study of women who underwent laparoscopic mesh sacrohysteropexy between 2010 and 2018. Potential participants were identified from surgical databases of five surgeons at two tertiary urogynaecology centres in the UK. The primary outcome was patient-reported mesh complication requiring removal of hysteropexy mesh. Secondary outcomes included other mesh-associated complications, reoperation rates and Patient Global Impression of Improvement (PGI-I) in prolapse symptoms. Descriptive statistics and Kaplan–Meier survival analyses were used. Results Of 1,766 eligible participants, 1,121 women responded (response proportion 63.5%), at a median follow-up of 46 months. The incidence of mesh complications requiring removal of hysteropexy mesh was 0.4% (4 out of 1,121). The rate of chronic pain service use was 1.8%, and newly diagnosed systemic autoimmune disorders was 5.8%. The rate of reoperation for apical prolapse was 3.7%, and for any form of pelvic organ prolapse it was 13.6%. For PGI-I, 81.4% of patients were “much better” or “very much better”. Conclusions Laparoscopic mesh sacrohysteropexy has a low incidence of reoperation for mesh complications and apical prolapse, and a high rate of patient-reported improvement in prolapse symptoms. With appropriate clinical governance measures, the procedure offers an alternative to vaginal hysterectomy with apical suspension. However, long-term comparative studies are still required. Electronic supplementary material The online version of this article (10.1007/s00192-020-04396-0) contains supplementary material, which is available to authorized users

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“…Studies 61–63 confirm good functional results using RAL, showing it to be efficacious in the management of vaginal vault prolapse. Since the first RAL for vesicovaginal fistula in 2005, more than 40 cases have been published 64–66 confirming the feasibility of this approach for the care of this complex condition.…”

Section: Role Of Robotic Surgery In Urogynaecologymentioning

confidence: 91%

Robotic surgery in gynaecology

Nobbenhuis¹,

Gul²,

Barton-Smith³

et al. 2022

BJOG

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Plain language summary The use of robotic‐assisted keyhole surgery in gynaecology has expanded in recent years owing to technical advances. These include 3D viewing leading to improved depth perception, limitation of tremor, potential for greater precision and discrimination of tissues, a shorter learning curve and improved comfort for surgeons compared with conventional keyhole and open abdominal surgery. Robotic‐assisted keyhole surgery, compared with conventional keyhole surgery, improves surgical performance without increasing operating time, minimises blood loss and intra‐ or postoperative complications, while reducing the need to revert to abdominal surgery. Moreover, surgeons using a robot experience fewer skeletomuscular problems of their own in the short and long term than those operating without a robot as an additional tool. This Scientific Impact Paper looks at the use of a robot in different fields of gynaecological surgery. A robot could be considered safe and a more effective surgical tool than conventional keyhole surgery for women who have to undergo complex gynaecology surgery or have associated medical issues such as body–mass index (BMI) at 30 kg/m2 or above or lung problems. The introduction of the use of robots in keyhole surgery has resulted in a decrease in the number of traditional open surgeries and the risk of conversion to open surgery after traditional keyhole surgery; both of which should be considered when examining the cost–benefit of using a robot. Limitations of robotic‐assisted surgery remain the associated higher costs. In womb cancer surgery there is good evidence that introducing robotics into the service improves outcomes for women and may reduce costs.

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Long-term follow-up and quality of life after robot assisted sacrohysteropexy

Abstract: RALS has proven to be a safe and effective treatment for uterine preserving surgery in cases of pelvic organ prolapse. The long term anatomical outcomes and quality of life after RALS compare favorably with laparoscopic and open hysteropexy.

Cited by 14 publications

References 21 publications

Laparoscopic Pectopexy: An Effective Procedure for Pelvic Organ Prolapse with an Evident Improvement on Quality of Life

Laparoscopic Pectopexy: An Effective Procedure for Pelvic Organ Prolapse with an Evident Improvement on Quality of Life

Long-term mesh complications and reoperation after laparoscopic mesh sacrohysteropexy: a cross-sectional study

Robotic surgery in gynaecology

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