Introduction:The gold standard treatment for managing patients with pelvic organ prolapse (POP) is sacrocolpopexy. Initially, open sacrocolpopexy was adopted; however, over the years classic laparoscopic approach and its modifications in the form of single port laparoscopy, NOTES (vaginal-assisted laparoscopy) and robotic-assisted laparoscopic sacrocolpopexy (LSC) have emerged. Usage of minimally invasive approaches has gained momentum in the recent past as they reduce the morbidity associated with open sacrocolpopexy, allowing faster recovery of the patient. Classic LSC has similar outcomes to abdominal sacrocolpopexy but is technically challenging especially due to the pelvic organ surgery offering limited area available for operating. Overcoming these limitations, by the characteristic features of the robotic system such as a "simulated wrist" of the mechanical arm with its enhanced freedom of movement along with a three-dimensional field of view, has attracted significant interest in recent years for robotic sacrocolpopexy (RSC). Aims: To evaluate outcomes and complications following minimally invasive sacrocolpopexy in patients with POP. Materials and methods:We evaluated a total of 20 patients with POP, 15 of those underwent LSC and five patients underwent RSC. We assessed outcomes in both these groups in terms of operating times, blood loss, blood transfusion, surgery-related complications, total hospital stay, and recurrence rates at 1-year follow-up. Results: Patients having RSC had a significantly lower rate of blood loss of ≤300 mL. Maximum postoperative complications were recorded as Clavien-Dindo grade I (seen in 75% of the patients). Most common among these were dysuria and urinary infection (seen in 40%). No Clavien-Dindo grade IVa, IVb, and V complications were recorded in either laparoscopic or robotic techniques conducted at our hospital. At 1 year of follow-up, no significant recurrence was seen in RSC (0%), while a low recurrence rate was seen in LSC (two patients, 13%). Conclusion:Robotic technology provides some advantages as compared to classic laparoscopic surgery. However, both approaches appear to provide equivalent clinical outcomes. But the cost of utilizing and maintaining the robotic system appears to be significant. Hence LSC is the suitable method of treating POP, especially in a country like India. However large randomized trials comparing both techniques are warranted.

Introduction: Involuntary loss of urine caused by raised intraabdominal pressure during exercise, coughing, or sneezing is known as stress urinary incontinence (SUI). Urinary incontinence affects over a quarter of women between the ages of 30 and 60, with SUI accounting for roughly half of the cases. Aging, smoking, straining, obesity, and COPD are all risk factors that may result in incontinence. Conservative therapy such as lifestyle changes, pelvic floor muscle training, bladder training, and medications are used as the first line of treatment for SUI. Surgery is recommended for patients who have not improved with conservative measures. Many surgical procedures are described to correct SUI. The essential premise in the therapy of SUI is to create functional kinking of the mid-urethra during episodes of raised intra-abdominal pressure to ensure adequate suspension. Two important sling methods are developed in the last two decades. Transobturator vaginal tape (TOT) technique is anatomically accurate and has the potential to reduce obstruction and postoperative voiding dysfunction. For the surgical treatment of SUI, these mid-urethral sling techniques became the gold standard. Aims: To study the postoperative complications, outcomes, and quality of life of patients undergoing TOT. Subjects and methods: This study is conducted prospectively from October 2018 to August 2021 on 24 genuine SUI patients, who underwent transobturator sling surgery in the Urology Department, Yenepoya Medical College, Mangaluru. The patients underwent all baselines and special examinations, such as an urodynamic study and a cystopanendoscopy. For the first 6 months, patients were treated with conservative therapy such as lifestyle changes, bladder training, pelvic floor exercise, and medications (duloxetine, imipramine, estrogens). All the patients who had failed or were dissatisfied with conservative treatment underwent the TOT treatment. Results: In total, 24 patients were assessed in this study. The patients ranged in age from 36 to 50 years old, with a mean age of 42.3 years. A total of 23 (95.8%) of the 24 patients were multiparous. All of the patients experienced involuntary urine leakage during straining, with 20 (83.3%) having grade II symptoms and 22 (91.6%) having symptoms for more than 3 years. Preoperatively, six (25%) of the patients had a minor cystocele, which was cleared after surgery. Diabetes mellitus/hypertension were present in four (16.6%) of the patients. ALPP ranged from 94 to 110 cm of water. All patients had maximal flow rate of more than 20 mL/second and a PVRU of less than 50 mL. The quality of life improved after surgery from a mean of 12.4 to 2.1. Urine flow rate was more than 20 mL/second in 19 patients (79.1%) after surgery, and 15-20 mL/second in 5 patients (20.8%) which improved after 3 months to more than 20 mL/second. In 20 (83.3%) patients, PVR urine was less than 50 mL, and in 4 (16.6%), it was between 50 and 100 mL. At 6-month follow-up, 22 (91.6%) patients were completely satisfied with the surgical...