PD44-08 POSTOPERATIVE OUTCOMES AFTER ROBOTIC SACROCOLPOPEXY WITH CONCURRENT RECTOPEXY IN WOMEN WITH MULTICOMPARTMENT PELVIC ORGAN PROLAPSE

Abstract

You have accessJournal of UrologyCME1 May 2022PD44-08 POSTOPERATIVE OUTCOMES AFTER ROBOTIC SACROCOLPOPEXY WITH CONCURRENT RECTOPEXY IN WOMEN WITH MULTICOMPARTMENT PELVIC ORGAN PROLAPSE Shivani Gaitonde, Jessie Chen, Craig Olson, Philippe Zimmern, and Maude Carmel Shivani GaitondeShivani Gaitonde More articles by this author , Jessie ChenJessie Chen More articles by this author , Craig OlsonCraig Olson More articles by this author , Philippe ZimmernPhilippe Zimmern More articles by this author , and Maude CarmelMaude Carmel More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002605.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Robotic assisted sacrocolpopexy (RSC) is an established surgical approach to correct pelvic organ prolapse (POP). However, relatively little data has been published regarding utilization of simultaneous rectopexy for patients with POP and defecatory dysfunction. The objective of this study was to describe outcomes of RSC with rectopexy versus RSC alone for patients with multicompartment POP. METHODS: Following IRB approval, we performed a retrospective analysis of women undergoing RSC with or without concurrent rectopexy at a single academic institution from December 2013 to May 2021. Pre- and postoperative demographics, pelvic organ prolapse quantification (POP-Q) score and assessment of defecatory dysfunction were reported. The primary outcomes were postoperative POP-Q Bp score, recurrence of symptomatic POP (POP-Q Ba or Bp>0) and need for additional POP surgery within 1yr. Secondary outcomes included complication rates and persistence of defecatory dysfunction. RESULTS: Of 162 women included in this study, 35 patients underwent combo RSC with rectopexy (22%) while the remainder underwent RSC only (n = 127, 78%). Mean age was 65yr (range 34-90) and BMI was 28.2 (range 19.4-51.4). Preoperative Bp (-1.5 in combo vs 0 in RSC-only), stage of posterior prolapse (mean stage 2 in both) and presence of external rectal prolapse (6% in both) did not significantly differ between groups. 71% of combo patients reported preop defecatory dysfunction vs 50% RSC-only patients. Mean postop follow-up was 23mo (range 1-82). Significantly more patients in the RSC-only group required repeat POP surgery within 1yr (0% combo vs 6% RSC-only, p < 0.05). The most common repeat surgery was posterior colporrhaphy (6/8 patients). However, by 1yr there were no differences in presence of symptomatic recurrent POP (5% combo vs 4% RSC-only) or reported defecatory dysfunction (34% combo vs 30% RSC-only). Median postop Bp was -3 in both groups. No intraoperative complications were noted in the combo group, while 3 patients in the RSC-only group had enterotomies repaired primarily. 2 combo patients had postoperative ileus managed conservatively (6%), and 2 had UTI (6%). 14 RSC-only patients had UTI (11%). CONCLUSIONS: Compared to RSC alone, combined RSC and rectopexy for women with multicompartment POP is associated with improved durability of posterior compartment repair without significant increase in adverse events. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e711 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Shivani Gaitonde More articles by this author Jessie Chen More articles by this author Craig Olson More articles by this author Philippe Zimmern More articles by this author Maude Carmel More articles by this author Expand All Advertisement PDF DownloadLoading ...