Is robotic-assisted sacrocolpo(hystero)pexy safe and effective in women over 65 years of age?

Abstract

The objective was to evaluate the safety and efficacy of robotic-assisted sacrocolpo(hystero)pexy in elderly patients with symptomatic apical pelvic organ prolapse and to compare the outcomes of open abdominal and robotic-assisted sacrocolpo(hystero)pexy in geriatric patients. Elderly patients (≥65years of age) who underwent open abdominal or robotic-assisted sacrocolpo(hystero)pexy for treatment of symptomatic grade 3 and 4 apical pelvic organ prolapse between November 2015 and May 2019 were evaluated retrospectively. The success rates of the procedures, the surgical outcomes, and the perioperative adverse events of both groups were compared. Perioperative adverse events were categorized according to the Clavien-Dindo classification. Forty-four patients underwent open abdominal sacrocolpo(hystero)pexy and 30 patients underwent robotic-assisted sacrocolpo(hystero)pexy. The mean age in the open abdominal sacrocolpo(hystero)pexy group was 68.4 ± 3.4years and in the robotic-assisted sacrocolpo(hystero)pexy group it was 69.7 ± 4.1years. The success rates in the open abdominal sacrocolpo(hystero)pexy and robotic-assisted sacrocolpo(hystero)pexy groups were 59% and 57% at median follow-up time of 28months and 24months respectively. Although the mean dosage of the analgesic (10.1mg/24h) and the mean length of hospital stay (2.1days) were significantly lower and shorter for the robotic-assisted sacrocolpopexy group, the mean duration of operation was considerably longer (141.2min). The rate of grade 2 or higher complications for open abdominal sacrocolpopexy was 16% (7 out of 44) and for robotic-assisted sacrocolpopexy it was 17% (5 out of 30). Anatomical outcomes and adverse events are similar in elderly patients undergoing open sacrocolpo(hystero)pexy and robotic-assisted sacrocolpo(hystero)pexy.