Women’s Preference for Cosmesis of Incisions Used for Open Versus Robotic Lower Urinary Tract Reconstructive Surgery

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OBJECTIVE: To compare the cosmetic appeal of incisions used for open (Pfannenstiel or Vertical midline) versus robotic-assisted laparoscopic lower urinary tract reconstructive surgery in women.
 STUDY DESIGN: Cross-sectional descriptive study
 PLACE AND DURATION: Outpatient Urology Clinic of Western General Hospital, Edinburgh Scotland, UK from 1st February 2019 till 28th February 2020. 
 METHODS: All patients were provided illustrations of Pfannenstiel incision (incision at “bikini line”- (A), Vertical midline laparotomy incision (incision from midline symphysis to umbilicus –( B), Robotic-assisted laparoscopic incisions-variation I- (C) and Robotic-assisted laparoscopic incisions-variation II (-D). Patients were asked to rate each incision in order of their preference. Chi square distribution was used to compare mean previous surgeries and no previous surgeries between different preferred incisional groups and ages of the patients.
 RESULTS: One hundred patients with mean age were 53.11±15.05 years with minimum 19 years and maximum 84 years and mean BMI was 28.18±7.05 kg/m2 with minimum 15.6 and maximum 55 kg/m2 calculated. Out of 100 patients (1st preference of incision), 78% preferred incision A, 3% preferred B incision and 16% & 3% patients preferred incision C and D respectively. Similarly (2nd preference of incision) 3% patients preferred incision A, 19% preferred B incision and 56% & 22% patients preferred incision C and D respectively. The mean comparison between first preferred incision with second preferred incision with respect of surgeries (previous surgeries and no previous surgeries) showed significant difference p≤0.05 (chi value=167.692, p=0.000). Relation of preferred incisions with respect to ages of the patients showed no significant difference (Pearson relation value -0.182 and p=0.069).
 CONCLUSION: Overall, open incisions were preferred over robotic incisions. Patient perception of the "visibility" of abdominal incisions and previous experience in term of surgical scars may be the distinguishing issue to explain the difference in the preferences between open versus robotic-assisted laparoscopic incisions in women.