V674 ROBOTIC SACRAL COLPOPEXY WITH CONCOMITANT SUPRACERVICAL HYSTERECTOMY

Abstract

You have accessJournal of UrologyFemale Voiding Dysfunction (Pelvic Reconstruction & Incontinence)1 Apr 2011V674 ROBOTIC SACRAL COLPOPEXY WITH CONCOMITANT SUPRACERVICAL HYSTERECTOMY Wesley White, Ryan Pickens, Robert Elder, and Frederick Klein Wesley WhiteWesley White Knoxville, TN More articles by this author , Ryan PickensRyan Pickens Knoxville, TN More articles by this author , Robert ElderRobert Elder Knoxville, TN More articles by this author , and Frederick KleinFrederick Klein Knoxville, TN More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.1626AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Conventionally, the treatment of female pelvic organ prolapse (POP) has come in the form of myriad vaginal repairs and/or abdominal sacral colpopexy (SCP). Although abdominal SCP offers superior and more durable outcomes, patients are often resistant to undergo an open repair that can be painful and cosmetically unpleasing. In response to these issues, laparoscopic and robotic abdominal approaches have been described that offer equivalent efficacy, expedited recovery, less discomfort, and are more esthetically pleasing compared to classic open repairs. Uterine preservation at the time of prolapse reduction is controversial and often dependent on patient preference. In appropriately selected candidates, robotic supracervical hysterectomy may be performed at the time of SCP and may facilitate and hasten reconstruction. We present our series of patients who underwent robotic SCP with concomitant supracervical hysterectomy. METHODS A prospective analysis was performed to evaluate perioperative and quality of life outcomes following robotic SCP for the treatment of symptomatic POP. All patients underwent multi-disciplinary history and physical including pelvic examination. Appropriate candidates underwent robotic SCP with concomitant supracervical hysterectomy and/or mid-urethral sling. Salient demographic and perioperative data was recorded. Patients were followed post-operatively for evidence of immediate and delayed adverse events as well as durability of the repair. RESULTS Between 01/01/2010 and 11/01/2010, 10 patients underwent robotic SCP with concomitant supracervical hysterectomy. Mean operative time was 114 minutes. Estimated blood loss was 40mL. There were no intraoperative complications or conversions. Mean length of hospitalization was 22 hours. There were no remote adverse events. At a mean duration of follow-up of 6 months, no patients have demonstrated objective evidence of recurrent prolapse. CONCLUSIONS Based on our experience, appropriately selected patients may undergo concomitant robotic supracervical hysterectomy at the time of SCP. Use of the cervical stump offers a robust platform for mesh fixation. A randomized, controlled trial is needed to determine the equivalence or superiority of robotic SCP with or without uterine preservation and/or SCP following prior hysterectomy. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e272-e273 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Wesley White Knoxville, TN More articles by this author Ryan Pickens Knoxville, TN More articles by this author Robert Elder Knoxville, TN More articles by this author Frederick Klein Knoxville, TN More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...