Robotic pelvic reconstruction for a case of multiple uterine myomas with acute urinary retention combined with pelvic organ prolapse and occult stress urinary incontinence

Abstract

Pelvic organ prolapse (POP) is the descent of the female organs that result in a protrusion of the vagina and/or uterus. Women often present with multiple complaints including bladder, bowel, and pelvic symptoms. Urinary retention was the symptom that woman presents uncommonly. Treatments of urinary retention were including removing the etiology of compression of the urethra and rescuing the normal position of pelvic organs. Surgery may be by abdominal, vaginal, or laparoscopic or robotic approach according to doctor's skillfulness, patient's need, and involving pelvic organs. Robotic technology has advantages of minimally invasive surgery such as reduced postoperative pain, shorter hospital stay, and quicker recovery times. It also has advantages of faster performance times, increased accuracy, enhanced dexterity, more accessible and more comfortable suturing, and a lower number of errors when compared to conventional laparoscopic instrumentation. Hence, it could be performed complex surgery such as this case. We present a case of multiple uterine myomas with compression symptoms and occult stress urinary incontinence. At the case of paravaginal wall defect with stress incontinence, she underwent robotic Burch colposuspension and paravaginal repair. Robotic pelvic reconstruction can be accomplished safely and efficiently and should be considered as an option for patients who had POP with urinary incontinence and who are prepared undergoing robotic surgery.