Robot-Assisted Sacrocolpopexy versus Trans-Vaginal Multicompartment Prolapse Repair: Impact on Lower Bowel Tract Function.
lower bowel tract symptoms
patient global impression improvement
pelvic organ prolapse
robotic-assisted sacrocolpopexy
transvaginal surgery
Journal
Biomedicines
ISSN: 2227-9059
Titre abrégé: Biomedicines
Pays: Switzerland
ID NLM: 101691304
Informations de publication
Date de publication:
26 Jul 2023
26 Jul 2023
Historique:
received:
21
04
2023
revised:
05
06
2023
accepted:
21
07
2023
medline:
26
8
2023
pubmed:
26
8
2023
entrez:
26
8
2023
Statut:
epublish
Résumé
This study evaluated the effectiveness, safety, and possible changes in bowel symptoms after multicompartment prolapse surgery by comparing two different surgical approaches, transvaginal mesh surgery with levatorplasty (TVMLP) and robot-assisted sacrocolpopexy (RSC). All patients underwent pelvic (POP-Q staging system) and rectal examination to evaluate anal sphincter tone in the lithotomy position with the appropriate Valsalva test. The preoperative evaluation included urodynamics and pelvic magnetic resonance defecography. Patient Global Impression of Improvement (PGI-I) at follow-up measured subjective improvement. All patients completed Agachan-Wexner's questionnaire at 0 and 12 months of follow-up to evaluate bowel symptoms. A total of 73 cases were randomized into the RSC group (36 cases) and TVMLP group (37 cases). After surgery, the main POP-Q stage in both groups was stage I (RCS 80.5% vs. TVMLP 82%). There was a significant difference ( RSC and TVMLP successfully corrected multicompartment POP. RSC showed a greater improvement in the total Agachan-Wexner score and lower bowel symptoms.
Sections du résumé
BACKGROUND
BACKGROUND
This study evaluated the effectiveness, safety, and possible changes in bowel symptoms after multicompartment prolapse surgery by comparing two different surgical approaches, transvaginal mesh surgery with levatorplasty (TVMLP) and robot-assisted sacrocolpopexy (RSC).
METHODS
METHODS
All patients underwent pelvic (POP-Q staging system) and rectal examination to evaluate anal sphincter tone in the lithotomy position with the appropriate Valsalva test. The preoperative evaluation included urodynamics and pelvic magnetic resonance defecography. Patient Global Impression of Improvement (PGI-I) at follow-up measured subjective improvement. All patients completed Agachan-Wexner's questionnaire at 0 and 12 months of follow-up to evaluate bowel symptoms.
RESULTS
RESULTS
A total of 73 cases were randomized into the RSC group (36 cases) and TVMLP group (37 cases). After surgery, the main POP-Q stage in both groups was stage I (RCS 80.5% vs. TVMLP 82%). There was a significant difference (
CONCLUSIONS
CONCLUSIONS
RSC and TVMLP successfully corrected multicompartment POP. RSC showed a greater improvement in the total Agachan-Wexner score and lower bowel symptoms.
Identifiants
pubmed: 37626605
pii: biomedicines11082105
doi: 10.3390/biomedicines11082105
pmc: PMC10452351
pii:
doi:
Types de publication
Journal Article
Langues
eng
Références
Am J Obstet Gynecol. 2007 Jul;197(1):76.e1-5
pubmed: 17618766
Dis Colon Rectum. 1996 Jun;39(6):681-5
pubmed: 8646957
Int Braz J Urol. 2020 Jan-Feb;46(1):5-14
pubmed: 31851453
Cochrane Database Syst Rev. 2018 Aug 19;8:CD013105
pubmed: 30121957
Female Pelvic Med Reconstr Surg. 2018 Nov/Dec;24(6):419-423
pubmed: 28786873
Female Pelvic Med Reconstr Surg. 2010 Jan;16(1):59-64
pubmed: 22453088
Int Urogynecol J. 2010 May;21(5):523-8
pubmed: 20013110
Surg Gynecol Obstet. 1953 Dec;97(6):677-92
pubmed: 13113550
Int Urogynecol J. 2012 Jun;23(6):743-7
pubmed: 22249278
Obstet Gynecol. 1998 Mar;91(3):364-8
pubmed: 9491861
Br J Obstet Gynaecol. 1989 Jan;96(1):15-23
pubmed: 2923839
Am J Obstet Gynecol. 2008 Dec;199(6):683.e1-7
pubmed: 18828990
Am J Obstet Gynecol. 2019 Nov;221(5):480.e1-480.e10
pubmed: 31128111
Br J Anaesth. 2012 Mar;108(3):430-5
pubmed: 22258201
Am J Obstet Gynecol. 2007 Dec;197(6):642.e1-8
pubmed: 18060963
Langenbecks Arch Surg. 2022 Jun;407(4):1693-1700
pubmed: 35113228
J Obstet Gynaecol Res. 2019 Apr;45(4):915-922
pubmed: 30652385
Int Urogynecol J Pelvic Floor Dysfunct. 2005 May-Jun;16(3):203-9; discussion 209
pubmed: 15875236
Minerva Obstet Gynecol. 2021 Apr;73(2):140-144
pubmed: 33103408
BMC Surg. 2022 Jul 11;22(1):268
pubmed: 35820857
Int Urogynecol J. 2016 Feb;27(2):165-94
pubmed: 26755051
Ann Transl Med. 2021 Mar;9(6):449
pubmed: 33850846