Advanced Cystocele is a Risk Factor for Surgical Failure after Robotic-assisted Laparoscopic Sacrocolpopexy

Anna Padoa*, Yair Shiber, Tal Fligelman, Roni Tomashev, Anna Tsviban, Noam Smorgick

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

12 Scopus citations

Abstract

Study Objective: To assess the outcome of robotic-assisted laparoscopic sacrocolpopexy (RALSCP) and to identify risk factors for surgical failure and long-term complications in patients at high risk for surgical failure. Design: Retrospective cohort study. Setting: A university hospital. Patients: Sixty-seven women with pelvic organ prolapse (POP) at high risk for surgical failure. Interventions: RALSCP from November 2012 to July 2020. Measurements and Main Results: Information was collected from the electronic medical records. Preoperative and postoperative assessment included urogynecologic history, prolapse staging, cough stress test, and validated quality of life questionnaires. Anatomic success was defined as POP stage < 2 at the last follow-up. Mean follow-up was 24.6 ± 17.9 months. Sixteen women (23.9%) reported bulge symptoms at the latest follow-up; upon POP Quantification staging, surgical failure or recurrence was observed in 35 patients (52.2%). On multiple logistic regression analysis, a preoperative POP Quantification point Ba measurement ≥3 cm beyond the hymen was independently related to surgical failure. Late postoperative complications included 3 cases (4.5%) of postoperative ventral hernia and 5 cases (7.5%) of mesh erosion, all in patients operated using Ethibond sutures. Conclusions: Anatomic success of RALSCP in POP patients at high risk for surgical failure is worse than previously reported. Advanced preoperative anterior vaginal wall prolapse is a risk factor for surgical failure. Delayed absorbable sutures for vaginal mesh fixation seem to be safer than multifilament, permanent sutures, in terms of the risk of mesh erosion.

Original languageEnglish
Pages (from-to)409-415
Number of pages7
JournalJournal of Minimally Invasive Gynecology
Volume29
Issue number3
DOIs
StatePublished - Mar 2022

Keywords

  • Complications
  • Pelvic organ prolapse
  • Quality of life
  • Robotic surgery
  • Success

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