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Robotic abdominal sacrocolpopexy/sacrouteropexy repair of advanced female pelvic organ prolaspe (POP): utilizing POP‐quantification‐based staging and outcomes
Author(s) -
Daneshgari Firouz,
Kefer John C.,
Moore Courtenay,
Kaouk Jihad
Publication year - 2007
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/j.1464-410x.2007.07109.x
Subject(s) - medicine , vagina , surgery , sling (weapon) , physical examination , stage (stratigraphy) , blood loss , paleontology , biology
Associate Editor Ash Tewari Editorial Board Ralph Clayman, USA Inderbir Gill, USA Roger Kirby, UK Mani Menon, USA OBJECTIVES To assess the management of advanced pelvic organ prolapse (POP) with robotic‐assisted abdominal sacrocolpopexy (RASC) and evaluate outcomes using the POP quantification scale (POP‐Q). PATIENTS AND METHODS Women with symptomatic stages III and IV POP were evaluated at our institution. After complete clinical assessment, including POP‐Q‐based physical examination and urodynamic studies, the patients underwent RASC with or without anti‐incontinence surgery in the presence (sacrouteropexy) or absence of uterus (sacrocolpopexy). Follow‐up examinations at 3 and 6 months included a POP‐Q‐based examination. RESULTS Fifteen women were consented for RASC; 12 underwent successful RASC, one required conversion to laparoscopic ASC, one to open ASC, and one to transvaginal repair. The mean (range) patient age was 64 (50–79) years. Before surgery, the mean POP‐Q stage was 3.1 (3–4) and the POP‐Q values for the anterior (Aa, Ba), posterior (Ap, Bp) and apex (C) of the vagina were: Aa − 0.9, Ba + 1.0, Ap − 1.0, Bp + 1.3, and C +2.1. After surgery, the mean POP‐Q stage was 0 and the POP‐Q values had improved to Aa − 2.29, Ba − 2.29, Ap − 2.65, Bp − 2.65, and C − 8.28. The mean (range) estimated blood loss during surgery was 81 (50–150) mL. The mean hospital stay was 2.4 (1–7) days. Seven patients had concurrent placement of a mid‐urethral sling and one patient had a concurrent Burch colposuspension. CONCLUSIONS These early results show that RASC is safe and efficacious, and that its anatomical outcomes compare favourably to the reported results for open or laparoscopic ASC.