Treatment Of Prolapse Research Articles

Anatomical and functional outcomes after bilateral sacrospinous colposuspension (BSC) for the treatment of female genital prolapse

BackgroundPelvic organ prolapse is a bothersome condition affecting many women at advanced age, but also frequently observed in young women with certain risk factors. Various surgical techniques have been developed with the aim of providing effective surgical treatment for apical prolapse. The vaginal bilateral sacrospinous colposuspension surgery (BSC) with ultralight mesh and utilization of the i- stich is a relatively new minimal invasive technique with very promising outcomes. The technique offers apical suspension, in the presence or absence of the uterus. The objective of this study is to evaluate the anatomical and functional outcomes of bilateral sacrospinous colposuspension with ultralight mesh in 30 Patients treated with the vaginal single incision standardized technique.MethodsIn this retrospective study, 30 patients were treated by BSC for significant vaginal, uterovaginal or cervical prolapse. A simultaneous anterior colporrhaphy, posterior colporrhaphy or both were performed when indicated. Anatomical and functional outcomes were assessed 1 year postoperatively using the Pelvic Organ Prolapse Quantification system (POP-Q) and the standardised Prolapse Quality of Life (P-QOL) questionnair.ResultsThe POP-Q parameters were significantly improved at twelve months after surgery compared to baseline. The total score and all four subdomains of the P-QOL-questionnaire showed positive trends and improvement at twelve months after surgery when compared to preoperative values. All patients were asymptomatic and expressed high satisfaction one year after surgery. No intraoperative adverse events were recorded for all patients. Only minimal postoperative complications were recorded and they all resolved completely with conservative management.ConclusionThis study highlights the functional and anatomical outcomes of the minimally invasive vaginal bilateral sacrospinal colposuspension with ultralight mesh for the management of apical prolapse. The one year postoperative results of the proposed procedure reflect excellent outcomes with minimal complications. The data published here are very promising and warrant further investigations and more studies to evaluate the long-term outcomes of BSC in the surgical management of apical defects.Trial registrationThe study protocol was approved by the Ethics Committee at the University Hospital of Cologne, Germany (Date of registration: 08.02.2022) (Registration number: 21-1494-retro) (retrospectively registered).

Hysteropexy and Anterior Vaginal Native Tissue Repair in Women with Anterior and Central Compartment Prolapse: A Long Term Follow-Up.

Although it is known that hysterectomy (HY) alone cannot resolve apical prolapse, vaginal hysterectomy (VH) remains the most common surgical procedure for this issue. In recent years, various procedures for uterine conservation have been proposed to avoid the surgical risks of HY. Furthermore, most women with symptomatic pelvic organ prolapse (POP) prefer uterine conservation in the absence of considerable benefit in uterine removal. In 2017, we proposed a new technique for hysteropexy and anterior vaginal native tissue repair (NTR) in women with cystocele and apical prolapse. The objective of this study is to assess the efficacy and safety of this new procedure after at least 5 years of follow-up. We included only patients with stage II or greater prolapse of the anterior vaginal wall and a concomitant stage II uterine prolapse in accordance with Pelvic Organ Prolapse Quantification (POP-Q) system. A Patient Global Impression of Improvement (PGI-I) score ≤ 2 in addition with the absence of POP symptoms was defined as subjective success. A descensus with a maximum point of less than -1 in any compartment was considered objective cure. A total of 102 patients who fulfilled the inclusion criteria were enrolled. At 60 months follow-up, 90 out of 102 patients (88%) were subjectively cured, whereas 88 out of the 102 (86%) patients were objectively cured. Subjective and objective cure rates persisted during the entire study period. Uni- and multivariate analysis of possible predictive factors associated with recurrence of prolapse showed that only a preoperative point C > 0 cm and BMI ≥ 25 kg/m2 were risk factors for failure. In conclusion, our study showed that hysteropexy with anterior vaginal native tissue repair may be an effective and safe option for the treatment of anterior vaginal prolapse and concomitant stage II uterine prolapse by at least 5 years of follow-up.

Pelvic floor muscle training as a method of prevention and treatment of pelvic floor dysfunction and genital prolapse

Relevance. Pelvic floor dysfunction and pelvic organ prolapse are a significant problem today - even the initial manifestations of pelvic floor dysfunction can lead to reduced quality of sexual life, decreased activity, and then to social isolation and decreased self-esteem of women. Due to the growth of general life expectancy, the incidence rate is also increasing. One of the most popular conservative treatments for pelvic floor dysfunction is pelvic floor muscle training. The aim of this literature review is to consolidate the scattered information about the effectiveness of pelvic floor muscle training as a prevention and treatment of pelvic floor dysfunction. Materials and Methods. In writing the review, publications from the PubMed and Google Scholar databases from January 2019 were analyzed and systematized. Results and Discussion. Pelvic floor muscle training is one of the most prospective methods of non-invasive treatment for pelvic organ prolapse. It can take many forms and is represented by a range of different techniques: from the simple short-term muscle contraction and Kegel exercises to more complex and high-tech methods using electromyostimulation and biofeedback. However, timing of introduction and method for pelvic floor muscle training must be carefully considered in order to gain the maximum result. Conclusion. Based on the study, it can be concluded that the introduction of pelvic floor muscle training as part of prenatal care and in the antenatal period is the most appropriate way to prevent pelvic floor failure and genital prolapse. Further research is required to confirm the hypothesis.

Key Roles of Conjunctiva Fornix-Bulbar Conjunctiva-Tenon Capsule in Conjoint Fascial Sheath Suspension.

Bulbar conjunctival prolapse is one of the complications of conjoint fascial sheath (CFS) suspension and has a negative impact on surgical results. To explore the prevention methods of this complication, the authors compared the incidence of it between the below-conjunctiva fornix-bulbar conjunctiva-Tenon capsule (CBT) approach and the above-CBT approach to dissecting CFS in CFS suspension and shared their experience in the treatment of bulbar conjunctival prolapse. From January of 2020 to August of 2021, 81 patients with severe congenital ptosis who underwent CFS suspension were enrolled and divided into two groups. Forty-five patients' (group A) CFS was dissected by means of the below-CBT approach and 36 patients' (group B) CFS was dissected by means of the above-CBT approach. Data regarding the incidence and outcomes of bulbar conjunctival prolapse and the postoperative condition were collected and analyzed. The incidence of bulbar conjunctival prolapse was 24.44% in group A and 2.78% in group B. Of the 12 bulbar conjunctival prolapse patients, seven patients' conditions improved after conservative treatment, and five did not. All of them underwent bulbar conjunctiva resection within 1 year and were cured. No recurrent prolapse was observed within 3 months postoperatively. At the last follow-up, the mean marginal reflex distance 1 and palpebral fissure height were 4.09 ± 0.19 mm and 9.85 ± 0.62 mm, respectively. There were no complications except lagophthalmos (16 eyelids), asymmetric eyelid contour (one patient), and trichiasis (two eyelids). The incidence of bulbar conjunctival prolapse decreased significantly by dissecting CFS by means of the above-CBT approach. For patients with bulbar conjunctival prolapse after CFS suspension, bulbar conjunctiva resection could provide satisfactory results. Therapeutic, IV.

Surgical treatment of stomal prolapse: A systematic review and meta-analysis of the literature.

This study aimed to assess success, recurrence, and overall complication rates among different surgical procedures for stomal prolapse. This study was a PRISMA-compliant systematic review. PubMed, Scopus, and Google Scholar were searched until March 2022. Studies that assessed surgical treatments of stomal prolapse in adults were included. The primary outcome was recurrence of stomal prolapse and the secondary outcome was 30-day complications. A random-effect meta-analysis was used to estimate the weighted mean rates of recurrence. Six studies published (111 patients; 103 males) were included. 52 (46.8%) patients had end colostomies, 35 (31.5%) had loop colostomies. Seven procedures were assessed and included local stoma reconstruction (40%), stapled local repair (27%), modified Altemeier technique (10%), mesh strip repair (9%), stoma relocation (6%) redo laparotomy repair (5%), and colectomy and end ileostomy (3%). The weighted mean recurrence rate after local stoma reconstruction was 37.2% (95% CI: -1.8 to 76.3), higher than that after the stapled local repair technique (14.9%; 95% CI: 1.7-28.2). The crude recurrence rate of the modified Altemeier technique was 20%, and of stoma relocation was 66.6%. No recurrence was detected after the mesh strip technique (n=10). The median follow-up ranged between 7 months and 2.5 years. Several surgical techniques are available to treat stomal prolapse. Local stoma reconstruction may be associated with high rates of recurrence while the stapled local repair and modified Altemeier procedure has relatively low recurrence. Further larger studies are needed to compare the efficacy of these techniques.

A comparative study between transanal and transabdominal approaches in treatment of complete rectal prolapse

There is a wide variety of surgical methods to treat rectal prolapse; however, to date, no clear agreement exists regarding the most effective surgical method. This study was designed to compare the results according to the surgical approach for complete rectal prolapse in women. This study was conducted from March 2016 to February 2021 on female patients with rectal prolapse who underwent surgery. First, all patients were classified into mucosal and complete layer groups to confirm the difference in results between the two groups, and only complete layer prolapse patients were divided into transanal and abdominal approaches to compare parameters and functional outcomes in each group. A total of 180 patients were included, with an average age of 71.7 years and 102 complete prolapses. The complete layer group was found to have more abdominal access, longer operating time, and higher recurrence rates compared to the mucosal layer group. (p<0.001) When targeting only the complete layer patients, there were 65 patients with the transanal and 37 with the abdominal (laparoscopic) approaches. The abdominal approach group had a longer operating time and hospital stay (p<0.001, respectively) and lower recurrence rate than the transanal group (transanal vs. abdominal, 38% vs. 10.8%, p=0.003), while the Wexner constipation and incontinence scores showed improved results in both groups. Although operating time and hospitalization period were shorter in the transanal group, laparoscopic abdominal surgery is a procedure that can reduce the recurrent rate for complete rectal prolapse.

Colpocleisis in the surgical treatment of pelvic organ prolapse: clinical experience

Aim: The objective of this study was to present the clinical experience with colpocleisis by evaluating patient characteristics and long-term follow-up data. Materials and Methods: This is a retrospective cohort study evaluating patients who underwent obliterative surgery for pelvic organ prolapse (POP) between 2010 and 2017. Patients who underwent colpocleisis without hysterectomy (C) (n=68) and colpocleisis of vaginal vault (CVV) (n=22) were included in this study. Results: The mean age of the study population was 72.7 years (range 55-89). The majority of the patients underwent colpocleisis as their primary surgical procedure for POP, as only 5.6% of the study group had a history of previous prolapse surgery. The mean follow-up duration was 49.5 months (range 1.5-109). Patient satisfaction with the surgery was high, with 98.9% of patients expressing they were “very satisfied” and 1.1% “satisfied”. There were two cases of recurrence (2.2%), and both were in the C group. One patient (1.1%) reported regret after surgery due to her husband's remorse about choosing an obliterative procedure. The recurrence rates, patient satisfaction, and regret were comparable between C and CVV groups. Conclusion: Colpocleisis is a viable option for the surgical treatment of POP, offering a high rate of success and patient satisfaction in long-term. Despite being an obliterative procedure, colpocleisis has acceptance as the primary surgical procedure by patients regardless of their marital status, and regret rate after surgery is low. Therefore, colpocleisis should be thoroughly discussed and included in the preoperative counseling and surgical planning of all patients with POP.

MODALITIES OF TREATMENT OF PELVIC ORGAN PROLAPSE IN A TERTIARY CARE HOSPITAL (GMCH) AND ITS SHORT TERM FOLLOW UP

Pelvic organ prolapse is an increasingly common condition seen in women with advancing age. The objective of this study is to observe the different modalities of treatment of pelvic organ prolapse and evaluate its outcome. In this study, all patients with pelvic organ prolapse, attending Gynae OPD or admitted in GMCH were included. In this study, 45(22.5%) patients were advised to use vaginal tamp Results: on, 9(4.5%) patients were advised Kegel's exercise, 125(62.50%) patients were treated with VH + PFR, , 15 (7.5%) patients underwent vaginal hysterectomy (VH), 4(2%) patients underwent VH + PFR + Sacrospinous xation and 2 (1%) patients were treated with Fothergills' surgery. The feedback received revealed that 118(59%) were satised and responded well to the treatment, 26 (13%) patients were not satised and from the remaining 56(28%) patients, no feedback had been received. It was observed that satisfaction was higher in patients who had surgical intervention.

TREATMENT TACTICS FOR GENITAL PROLAPSES IN WOMEN WITH ABNORMAL UTERINE BLEEDING AND THYROID GLAND PATHOLOGY

Introduction. Patients with genital prolapse have various extragenital pathologies, in particular thyroid pathology, which affects the regulation of the menstrual cycle both in the reproductive and perimenopausal periods of a woman's life. Abnormal uterine bleeding caused by hormonal disorders, functional and organic changes in the thyroid gland is reported as a common problem of perimenopausal age. The aim of this study is to optimize the treatment of genital prolapse in women with abnormal uterine bleeding and thyroid pathology. Materials and methods. 49 perimenopausal women with genital prolapse who had thyroid pathology were examined and treated. They were divided into the main group (29 women with abnormal uterine bleeding) and the comparison group of 20 patients with genital prolapse without abnormal uterine bleeding. 20 women without signs of gynaecological and extragenital pathology made up the control group. Results. The presence of significant deviations in the serum content of steroid hormones in women with thyroid dysfunction allows us to confirm the relationship between proliferative processes in the endometrium and the functioning of the thyroid system. The examination revealed a significant relationship between thyroid dysfunction and the cause of abnormal uterine bleeding. Depending on the treatment method, the women of the main group were divided into 2 subgroups: the first subgroup included 19 patients who underwent vaginal extirpation of the uterus and simultaneous correction of genital prolapse with additional sacrospinal fixation of the vaginal stump using a mesh implant fragment. 10 patients were included in the second subgroup, which underwent hysteroresectoscopy due to abnormal uterine bleeding, and surgical treatment of genital prolapse was performed after a certain period of time (after 0.5-3 years, on average after 21-24 months). In the comparison group, planned vaginal extirpation of the uterus was performed. Conclusion. The improvement of the treatment of genital prolapse in women with abnormal uterine bleeding and thyroid pathology consists in combining vaginal removal of the uterus followed by strengthening of the vaginal dome through the use of sacrospinal fixation and/or a mesh implant in order to prevent recurrences and improve the economic indicators of the medical institution and the quality of life of patients.

The anatomy of the sacrospinous ligament: how to avoid complications related to the sacrospinous fixation procedure for treatment of pelvic organ prolapse.

Historically, the sacrospinous ligament (SSL) has been used to treat POP in order to restore the apical compartment through a posterior or an anterior vaginal approach. The SSL is located in a complex anatomical region, rich in neurovascular structures that must be avoided to reduce complications such as acute hemorrhage or chronic pelvic pain. The aim of this three-dimensional (3D) video describing the SSL anatomy is to show the anatomical concerns related to the dissection and the suture of this ligament. We conducted a research of anatomical articles about vascular and nerve structures located in the SSL region, in order to increase the anatomical knowledge and show the best placement of sutures to reduce complications related to SSL suspension procedures. We showed the medial part of the SSL to be most suitable for the placement of the suture during SSL fixation procedures, in order to avoid nerve and vessel injuries. However, nerves to the coccygeus and levator ani muscle can course on the medial part of the SSL, the portion of the SSL where we recommended to pass the suture. Knowledge of the SSL anatomy is crucial and during surgical training it is clearly indicated to stay far away (almost 2 cm) from the ischial spine to avoid nerve and vascular injuries.

Patient-Specific Pessaries for Pelvic Organ Prolapse Using Three-Dimensional Printing: A Pilot Study.

Vaginal pessaries are an effective nonsurgical treatment for pelvic organ prolapse (POP) when properly fitted. However, pessary fitting and use are often unsuccessful or imperfect. The objective of this study was to assess the feasibility of using patient-specific pessaries fabricated from three-dimensional (3D)-printed molds to improve POP symptoms and increase overall satisfaction of pessary treatment in patients using standard vaginal pessaries. Patients undergoing POP treatment with standard vaginal pessaries were enrolled in this pilot prospective study. Patient-specific pessaries were designed and fabricated for each patient using patient input, physician input, and anatomic measurements from clinical assessment. Pessary fabrication involved injection of biocompatible liquid silicone rubber into 3D-printed molds followed by a biocompatible silicone coating. Pelvic organ prolapse symptomatic distress and pessary treatment satisfaction were evaluated before and after a 3-week patient-specific pessary home trial using the validated Pelvic Organ Prolapse Distress Inventory-6 form and a visual analog scale, respectively. Eight women were included in this study. Changing from standard pessary to patient-specific pessary treatment was associated with an improvement in prolapse symptoms on the Pelvic Organ Prolapse Distress Inventory-6 (median change, -3.5; interquartile range, -5 to -2.5; P = 0.02) and an increase in overall pessary satisfaction on a visual analog scale (median change, +2.0; interquartile range, +1.0 to +3.0; P = 0.02). All patients reported either an improvement or no change in pessary ease of use, comfort, and the feeling of support provided by the pessary. Patient-specific vaginal pessaries are a promising alternative to standard pessaries for alleviating POP symptoms and improving patient satisfaction with pessary use.

Success After Treatment of Pelvic Organ Prolapse With Surgery or Pessary Remains a Patient-Centered Choice

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Robot-assisted sacrohysteropexy vs robot-assisted sacrocolpopexy in women with primary advanced apical prolapse: A retrospective cohort study.

This study aimed to evaluate the anatomic and clinical outcomes of robot-assisted sacrohysteropexy (RASH) against robot-assisted sacrocolpopexy (RASC) for the treatment of primary advanced apical prolapse. We conducted a retrospective cohort study of all robot-assisted pelvic organ prolapse surgeries for primary advanced apical prolapse (stage ≥II) between January 2011 and May 2021 at an academic tertiary hospital. Surgical outcomes and pelvic organ function were evaluated using the Pelvic Organ Prolapse Quantitative (POP-Q) stage and validated questionnaires (POPDI-6) during preoperative and postoperative 12-month follow-up evaluations. All data were obtained from electronic medical records. A total of 2368 women underwent surgery for apical prolapse repair, and 18 women underwent either RASH (n = 11) or RASC (n = 7). Compared to the RASC group, the RASH group was significantly younger, premenopausal, and less parous. Preoperative prolapse stage, operative time, estimated blood loss, and hospitalization length was comparable between the groups. No intraoperative complications were observed. All women had a median follow-up duration of 24 months (range: 12-108 months). During the 12-month follow-up period, women in the RASH group reported higher satisfaction with the surgery than those in the RASC group (100% vs. 71.4%, p = 0.137). The mesh exposure rate was significantly higher in the RASC group (3/7, 42.9%) than in the RASH group (0/11, 0%) ( p = 0.043), which was found at 12 to 36 months postoperatively and was successfully managed with vaginal estrogen cream. In the RASH group, one woman required reoperation with anterior colporrhaphy for recurrent anterior prolapse at 60 months postoperatively. The apical success rate was 100% at one year postoperatively, without apical recurrence in either group during the follow-up period. RASH represents an effective and feasible option for the surgical treatment of advanced primary apical prolapse in women who desire uterine preservation and have a significantly lower risk of mesh erosion than RASC.

Cervical Cancer in Case with Pelvic Organ Prolapse (POP) and Stress Urinary Incontinence (SUI)

Background: Combined cervical cancer and pelvic organ prolapse (POP) is extremely uncommon and there is no standard treatment guideline for the complex comorbidity. We attempted to provide a treatment strategy and explore possible reasons for the comorbidities. Case presentation: We presented a 62-year-old patient seeking treatment for postmenopausal tissue prolapse and leakage of urine. The gynecologic examination revealed the uterine prolapse with a 2.5 cm papillary and erosive lesion on the cervix that was pathologically confirmed as cervical squamous cell carcinoma in stage Ib1. Clinical diagnosis included cervical squamous cell carcinoma in stage Ib1, prolapse of uterus and vagina, stress urinary incontinence (SUI). Then she was performed radical surgery for cervical cancer and tension-free vaginal tape-obturator (TVT-O). The urine function was good after operation. The surgery solved two diseases, which improved the quality of life (QOL) of patient and radically cured cervical carcinoma at the same time. Follow up for more than two years, HPV was negative, no prolapse symptoms occurred, and the quality of life was good. Conclusions: Surgical-based treatment seems to be more suitable that can cure the two diseases and improve the QOL. We should pay attention to the potential high incidence of HPV infection and HPV-related cervical cancer so that we should not ignore the screening for cervical cancer in the prolapse group and initiate surgery treatment strategies of cervical cancer or pre-cancerous lesions as early as possible to reach an optimal outcome of patient.

Patient reported lower urinary tract symptoms following surgical treatment of apical pelvic organ prolapse

Patient reported lower urinary tract symptoms following surgical treatment of apical pelvic organ prolapse

Same day discharge vs. planned admission following surgical treatment for apical prolapse

Same day discharge vs. planned admission following surgical treatment for apical prolapse

The safety and effectiveness of laparoscopic anterior sacral ligament suspension combined with dome suspension in the treatment of bladder prolapse after hysterectomy: a retrospective cohort study.

Laparoscopic anterior sacral ligament suspension combined with dome suspension (L-ASLS + DS) and transperineal whole pelvic floor reconstruction (T-WPFR) are 2 methods for treating bladder prolapse after hysterectomy. In clinical practice, we found that L-ASLS + DS has better safety and effectiveness than T-WPFR, but there is no relevant study comparing the safety and effectiveness of these two methods. We sought to compare the efficacy and safety of L-ASLS + DS and T-WPFR in treating hysterectomy-induced bladder prolapse overa 1-year follow-up period. A total 146 patients with bladder prolapse after hysterectomy who attended Shanxi Provincial People's Hospital from January 2011 to January 2022 were included in this study. Patients were divided into study group and control group by voluntary means or economic reasons. In total, 75 patients received L-ASLS + DS surgery and 71 patients received T-WPFR surgery to treat hysterectomy-induced bladder prolapse. The L-ASLS + DS-treated patients comprised the study group, while the T-WPFR-treated patients comprised the control group. The perioperative indicators, curative effect, and postoperative complication rates in the follow-up period were compared between the 2 groups. L-ASLS + DS outperformed T-WPFR in terms of the perioperative indicators, and the incidence of postoperative complications in the L-ASLS + DS group was significantly lower than that in the T-WPFR group. L-ASLS + DS can be used to effectively treat bladder prolapse after hysterectomy. L-ASLS + DS reduced the incidence of postoperative complications, improved the cure rate, and was shown to be safe. Thus, it is worthy of comprehensive clinical application.

Patient educational video to enhance patient decision satisfaction for the treatment of pelvic organ prolapse

Patient educational video to enhance patient decision satisfaction for the treatment of pelvic organ prolapse

Surgical management of genital prolapse and combined gynecological pathologies in women: A meta-analysis

&lt;b&gt;Introduction:&lt;/b&gt; Prolapse can be fixed using a variety of surgical procedures. The goal of the present study was to examine the current literature on various surgical techniques for treating female genital organ prolapse.&lt;br /&gt; &lt;b&gt;Methods:&lt;/b&gt; The PubMed and Medline databases were explored for pertinent literature up through August 2022 for this meta-analysis. The terms [surgery] AND [management] AND [genital prolapse OR gynaecological diseases] AND [randomised control studies OR randomised control trials] were used as search criteria. The studies that met the inclusion criteria were considered qualified using the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Cochrane handbook of “Systematic reviews of interventions” was used for risk of bias assessment.&lt;br /&gt; &lt;b&gt;Results:&lt;/b&gt; The investigations found significant difference in the heterogeneity between the groups with a 76% I&lt;sup&gt;2&lt;/sup&gt; value (p&amp;lt;0.00001). There was little variability among the six trials that examined robotic and laparoscopic therapy of prolapse (I&lt;sup&gt;2&lt;/sup&gt;=0%, p=0.94). In six investigations, the odd ratio revealed no statistically significant difference between groups (1.05; 95% CI, 0.52, 2.12). However, generally there were no appreciable differences between robotic and laparoscopic treatment of female prolapse. There was a low-risk bias among the selected studies.&lt;br /&gt; &lt;b&gt;Conclusion:&lt;/b&gt; According to this meta-analysis study, laparoscopic surgery performed better job of managing prolapse than abdominal surgery.

HUGO(TM) RAS System in urogynaecology: the first nerve sparing Sacral Colpopexy for Pelvic Organ Prolapse.

Minimally invasive sacral colpopexy is considered the gold standard for surgical treatment of Pelvic Organ Prolapse (POP), combining high success rates with low recurrence risk in comparison to other techniques. This is the first case of robotic sacral colpopexy (RSCP) performed with the innovative Hugo™ RAS robotic system. The aim of this article is to show the surgical steps of a nerve sparing RSCP performed with the new Hugo™ RAS robotic system (Medtronic), by also evaluating the feasibility of this technique using this novel Robotic System. A 50-year-old Caucasian woman with symptomatic pelvic organ prolapse (POP-Q): Aa: +2, Ba: +3, C: +4, D: +4, Bp: -2, Ap: -2 , TVL:10 GH: 3,5 BP:3 underwent RSCP as well as a subtotal hysterectomy with bilateral salpingo-oophorectomy, using the new surgical robot Hugo™ RAS in the Division of Urogynaecology and Pelvic Reconstructive Surgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. Intraoperative data, docking specifics, objective and subjective outcomes at three months follow up. Surgical procedure was carried out without intra-operative complications, operative time (OT) was 150 minutes, docking time was 9 minutes. No system errors or faults in the robotic arms were registered. Urogynaecological examination at three months follow up showed a complete resolution of the prolapse. RSCP using the Hugo™ RAS system seems to be a feasible and effective approach according to results in terms of operative time, cosmetic results, postoperative pain and length of hospitalisation. Large number of case reports as well as longer follow up are mandatory to better define its benefits, advantages, and costs.