Comparison of robot-assisted vs. traditional laparoscopic sacral colpopexy for pelvic organ prolapse: Outcomes and quality of life

Abstract

Background Pelvic organ prolapse is a prevalent condition affecting women of varying ages and ethnicities globally. The prevalence of pelvic organ prolapse is substantial, with estimates suggesting that up to 50% of parous women may experience some degree of prolapse during their lifetime. Objective This retrospective evaluation aimed to compare the outcomes of robot-assisted sacral colpopexy (RASC) and traditional laparoscopic sacral colpopexy (LSC) in the treatment of pelvic organ prolapse, focusing on surgical outcomes, postoperative pain, quality of life, complications, and recurrence rates. Methods A total of 138 patients treated for pelvic organ prolapse and undergoing sacral colpopexy from December 2021 to December 2023 were included in the study. The patients were categorized into two groups based on the procedure utilized: RASC or LSC. Demographic characteristics, surgical outcomes, postoperative pain scores, quality of life, complications, and recurrence rates were compared between the two groups. Results The demographic characteristics of the study population demonstrated comparable baseline profiles for the RASC and LSC groups. RASC was associated with shorter surgery duration, lower intraoperative blood loss, shorter operative time for apical prolapse repair, and significantly lower postoperative pain scores at 24, 48, and 72 h postoperatively compared to LSC. Additionally, patients undergoing RASC demonstrated significantly better quality of life across various domains compared to those undergoing LSC. There were no statistically significant differences in the incidence of complications between the two groups. Furthermore, the RASC group demonstrated consistently lower recurrence rates at 1, 2, and 5 years postoperatively compared to the LSC group. Conclusion Robot-assisted sacral colpopexy offers potential advantages over traditional laparoscopic sacral colpopexy in the treatment of pelvic organ prolapse, with favorable surgical outcomes, reduced postoperative pain, improved quality of life, comparable complication rates, and lower recurrence rates. These findings support the consideration of RASC as a promising surgical approach for addressing pelvic organ prolapse and provide valuable insights for informing clinical decision-making and refining the approach to pelvic organ prolapse treatment.