Outcomes of Robotic Sacrocolpopexy

Hudson, Catherine; Northington, Gina M.; Lyles, Robert H.; Karp, Deborah R.

doi:10.1097/spv.0000000000000070

Cited by 64 publications

(19 citation statements)

References 29 publications

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“…In our study, preoperative and postoperative POP-Q measurements predictably improved following surgical intervention, regardless of cohort. Our findings are consistent with a meta-analysis by Hudson et al ( 27 ), who observed an overall anatomical success rate of 98.6% ( 27 ). However, the mean follow-up from this meta-analysis was 26.9±17.3 months as compared to our study that used a relatively short 12-week follow-up period.…”

Section: Discussionsupporting

confidence: 93%

Does ventral mesh rectopexy at the time of sacrocolpopexy prevent subsequent posterior wall prolapse?

Baracy¹,

Richardsona²,

Mackeya³

et al. 2021

J Turkish German Gynecol Assoc

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Objective: To determine whether ventral mesh rectopexy at the time of sacrocolpopexy reduces the rate of future posterior wall prolapse. Material and Methods: This was a retrospective cohort study of women with pelvic organ prolapse (POP) who underwent sacrocolpopexy or without concomitant rectopexy at a single community hospital from December 1, 2015 to June 30, 2019. Preoperative pelvic organ prolapse quantification (POP-Q) and urodynamic testing was used in evaluation of POP. Patients were followed for 12-weeks postoperatively and a 12-week postoperative POP-Q assessment was completed. The incidence of new or recurrent posterior prolapse was compared between cohorts. Results: Women with POP (n=150) were recruited, of whom 41 (27.3%) underwent sacrocolpopexy while the remainder (n=109, 72.7%) did not receive rectopexy. Patient demographics did not statistically differ between cohorts. Post-surgical posterior wall prolapse was reduced in the robotic assisted sacrocolpopexy (RASC) + rectopexy group compared to RASC alone, however this did not reach statistical significance. There were no patients who underwent concomitant rectopexy and RASC that needed recurrent posterior wall prolapse surgery, compared to eight-percent of patients that underwent isolated RASC procedures. Conclusion: Our findings suggest a reduction in the need for subsequent posterior wall surgery when rectopexy is performed at the time of sacrocolpopexy. In our study, no future surgery for POP was found in the concomitant sacrocolpopexy and rectopexy group, while a small proportion of the RASC only group required future POP surgery. Our study, however, was underpowered to elucidate a statistically significant difference between groups. Future larger studies are needed to confirm a reduced risk of posterior wall prolapse in patients who undergo concomitant RASC and rectopexy.

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Section: Discussionsupporting

confidence: 93%

Does ventral mesh rectopexy at the time of sacrocolpopexy prevent subsequent posterior wall prolapse?

Baracy¹,

Richardsona²,

Mackeya³

et al. 2021

J Turkish German Gynecol Assoc

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“…13 Other studies, too, have shown improvement in QOL scores using the PFDI and the PFIQ. 14–18 In a recently published study by Jong and colleagues, following robotic mesh sacrocolpopexy of 56 women with a mean follow-up time of 3 years, mean AUA QOL score improved significantly from a mean of 4–1.78 postoperatively. However, the mean UDI-6 score did not improve to a level of statistical significance (5–4.59, p = 0.40).…”

Section: Discussionmentioning

confidence: 97%

“…Our concomitant rectocele repair rate of 24.4% is slightly higher than those reported in a 2014 meta-analysis of 13 studies, showing that 18.5% of patients have a rectocele repair at the time of robotic sacrocolpopexy. 15 However, in a Paraiso’s cohort of 40 robotic sacrocolpopexy cases, rectocele was performed in 29% of patients. 17…”

Section: Discussionmentioning

confidence: 99%

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

Vollstedt

Meeks

Triaca

2019

Therapeutic Advances in Urology

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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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“…Our results are similar to other authors who observed PFDI-20 to be useful in vault prolapse and to see the impact of surgical method including robotic surgery. [ 25 ] It can be seen that surgical treatment of vault prolapse by both vaginal and abdominal routes significantly lowered PFDI-20 and improved the quality of life of patients suffering from vault prolapse with no significant difference in two techniques of vault prolapse surgery.…”

Section: Discussionmentioning

confidence: 99%

Role of preoperative and postoperative pelvic floor distress inventory-20 in evaluation of posthysterectomy vault prolapse

et al. 2021

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Background: Posthysterectomy vault prolapse is a common problem after vaginal or abdominal hysterectomy. The objective was to assess the role of Pelvic Floor Distress Inventory 20 (PFDI-20) in evaluation of vault prolapse. Materials and Methods: Prospective study in 20 women with posthysterectomy vault prolapse of Stage 2 and above. The outcome measure was to calculate PFDI-20 score in all cases before surgical intervention and to recalculate it again in 6 months after different surgical procedures for vault prolapse and to statistically compare the PFDI-20 score in different types of surgery over 4 years period at a tertiary referral hospital for surgical treatment. Prolapse was classified using Pelvic Organ Prolapse Quantification and intraoperative findings. All women were operated for vault prolapse as per hospital protocol and stage of prolapse by either vaginal sacrospinous fixation or abdominal sacrocolpopexy. Results: Mean age, parity, and body mass index were 54.8 years, 3.5, and 22.71 kg/m 2 respectively. Preceding surgery was vaginal hysterectomy in 75% women and abdominal hysterectomy in 25% women. Complaints were bulge or mass feeling at perineum (100%), pressure in lower abdomen and perineum (55%), and constipation (60%). The type of prolapse was vault prolapse (100%), cystocele (100%), rectocele (100%), and enterocele (45%). The range of PFDI-20 was 88–152 with mean being 123.50 ± 22.71 before surgery while its range decreased significantly to 80–126 with mean being 106.40 ± 16.45 after surgery ( P < 0.01). Mean postoperative PFDI-20 score was 107.40 in vaginal sacrospinous fixation group and was 105.30 in abdominal sacrocolpopexy group and was not statistically different ( P = 0.18). Conclusion: PFDI-20 score can be used to see the adverse impact of vault prolapse on pelvic floor and to assess the beneficial effect of different types of surgeries on the score.

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Outcomes of Robotic Sacrocolpopexy

Cited by 64 publications

References 29 publications

Does ventral mesh rectopexy at the time of sacrocolpopexy prevent subsequent posterior wall prolapse?

Does ventral mesh rectopexy at the time of sacrocolpopexy prevent subsequent posterior wall prolapse?

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

Role of preoperative and postoperative pelvic floor distress inventory-20 in evaluation of posthysterectomy vault prolapse

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