Very long-term outcomes of robotic mesh sacrocolpopexy for pelvic organ prolapse repair.

Abstract

To assess the very long-term functional outcomes and complications of robot-assisted sacrocolpopexy (RASC) at our institution where this robotic technology for pelvic organ prolapse (POP) repair has been available since 2006. A retrospective review of a cohort of women who underwent a RASC was performed by an investigator not involved in the clinical care of these patients. Women with no electronic medical record follow-up in the last 2 years were contacted by telephone. The primary outcome was RASC success defined as (1) no self-report of vaginal bulge, (2) no prolapse beyond the hymen (POP-Q > 0), and (3) no retreatment for prolapse (surgery, pessary). Postoperative symptomatic urinary incontinence (UI), anorectal dysfunction, dyspareunia and any late complication were secondary outcomes. Of 100 women who underwent RASC between 2007 and 2018, 79 patients with a median age of 66 years (IQR 58-71) were included. Median follow-up was 69 months (28-117), with a last visit more than 5 years postoperatively in 48 patients and more than 10 years in 19 patients. A total of 59 patients (75%) met the definition of success. A bothersome vaginal bulge was reported in 18 patients (23%), prolapse beyond the hymen was observed in 12 patients (16%), and further surgery for POP was performed in 9 patients (12%). Twenty-three patients reported postoperative UI (32%) and 21 reported postoperative anorectal dysfunction (39%). RASC provided good long-term results with an unpredictable risk of recurrence independent of the timeline.