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Introduction and Hypothesis <p>The aim of the study was to compare clinical outcomes when using robotic-assisted sacral hysterocolpopexy (RASC) and vaginal surgery using the Uphold™ Vaginal Support System mesh for pelvic organ prolapse repair.</p> Methods <p>This was a nonrandomized, prospective, multicenter study in which 72 women underwent RASC, and 73 Uphold™ surgery, for apical prolapse (POP-Q C ≥ stage II). Anatomical outcomes were assessed using the Pelvic Organ Prolapse Quantification (POP–Q) system. Subjective outcomes were evaluated using the Pelvic Floor Distress Inventory 20 (PFDI-20), the Pelvic Floor Impact Questionnaire – short form (PFIQ-7), and the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12), as well as pain estimation using the visual analog scale (0–10).</p> Results <p>One year after surgery, an optimal apical segment outcome (POP-Q C stage 0–1) was achieved in 96.4% and 93.3% for the RASC and Uphold™ respectively, <i>p</i> = 0.49. However, reoperation for prolapse recurrence was significantly more common after RASC (11 out of 72 [15.3%] vs Uphold™ (2 out of 71 [2.8%], <i>p</i> = 0.005), and an optimal outcome of the anterior vaginal wall was higher after Uphold™ (<i>p</i> &lt; 0.001). Postoperative PFDI-20, PFIQ-7, and pain significantly improved for both RASC and Uphold™ (<i>p</i> = 0.004 to &lt; 0.001), but a more pronounced improvement in the total PFDI-20 and POPDI-6 sub-scores was observed after Uphold™ than after RASC (−73 ± 55.6 vs −49.2 ± 43.7, <i>p</i> = 0.005 and −39.6 ± 23.6 vs −27 ± 23.9, <i>p</i> &lt; 0.001 respectively).</p> Conclusions <p>Reoperation for prolapse recurrence within 1 year was more common after RASC than after Uphold™. However, the rate of complications was low overall and there were few and largely insignificant differences in outcomes when comparing RASC and Uphold™.</p>

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Pelvic Organ Prolapse Repair Using Robotic-Assisted Sacral Hysterocolpopexy vs Vaginal Surgery with the Uphold™ System: 1-Year Clinical Outcomes

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年1月8日

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  • Georgios Poutakidis,
  • Christian Falconer,
  • Daniel Altman,
  • Ulrika Johannesson,
  • Anju Zhang,
  • Charlotta Ericson,
  • Mats Stenberg,
  • Sabine Altrock,
  • Edward Morcos

摘要

Introduction and Hypothesis

The aim of the study was to compare clinical outcomes when using robotic-assisted sacral hysterocolpopexy (RASC) and vaginal surgery using the Uphold™ Vaginal Support System mesh for pelvic organ prolapse repair.

Methods

This was a nonrandomized, prospective, multicenter study in which 72 women underwent RASC, and 73 Uphold™ surgery, for apical prolapse (POP-Q C ≥ stage II). Anatomical outcomes were assessed using the Pelvic Organ Prolapse Quantification (POP–Q) system. Subjective outcomes were evaluated using the Pelvic Floor Distress Inventory 20 (PFDI-20), the Pelvic Floor Impact Questionnaire – short form (PFIQ-7), and the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12), as well as pain estimation using the visual analog scale (0–10).

Results

One year after surgery, an optimal apical segment outcome (POP-Q C stage 0–1) was achieved in 96.4% and 93.3% for the RASC and Uphold™ respectively, p = 0.49. However, reoperation for prolapse recurrence was significantly more common after RASC (11 out of 72 [15.3%] vs Uphold™ (2 out of 71 [2.8%], p = 0.005), and an optimal outcome of the anterior vaginal wall was higher after Uphold™ (p < 0.001). Postoperative PFDI-20, PFIQ-7, and pain significantly improved for both RASC and Uphold™ (p = 0.004 to < 0.001), but a more pronounced improvement in the total PFDI-20 and POPDI-6 sub-scores was observed after Uphold™ than after RASC (−73 ± 55.6 vs −49.2 ± 43.7, p = 0.005 and −39.6 ± 23.6 vs −27 ± 23.9, p < 0.001 respectively).

Conclusions

Reoperation for prolapse recurrence within 1 year was more common after RASC than after Uphold™. However, the rate of complications was low overall and there were few and largely insignificant differences in outcomes when comparing RASC and Uphold™.