Comparison of Robotic-Assisted and Abdominal Hysterectomy with Concomitant Burch Colposuspension

Abstract

Background: Stress urinary incontinence (SUI) affects *30% of all women; 4% need surgery; and SUI is most often seen in women ages 25-50. There are >200 surgical treatment methods. Burch colposuspension (BC) and sling operations are used widely today. Objective: Short-term results of robotic-assisted and abdominal approaches were evaluated in patients who had hysterectomies with BC. Materials and Methods: This crosssectional study involved 40 patients with SUI and benign gynecologic conditions. The patients received either robotic-assisted hysterectomy with BC (Surgery A; 20 patients) or abdominal hysterectomy and BC (Surgery B; 20 patients). All patients were assessed at the Gulhane Military Medical Academy, in Etlik, Ankara, Turkey. The patients' demographics; intraoperative findings; complications; preoperative and postoperative 6th month Urinary Distress Inventory short form (UDI-6), urinary Incontinence Impact Questionnaire short form (IIQ-7) scores; and postoperative 6th month continence situations and values were assessed. Results: The median ages of the patients who received Surgery A and Surgery B procedure were 50 and 48, respectively. Both surgical groups were similar at baseline with respect to age, body mass index, gravidity, parity, operation time, and suturing time. None of these comparisons appeared to be significantly different ( p > 0.05). Blood loss and hospitalization periods were statistically different between groups A and B ( p < 0.05). No statistical difference was detected in UDI-6 and IIQ-7 scores before and after Surgeries A and B. No incontinence was observed in either group at their postoperative 6th month continence assessments. Conclusions: In this small sample of patients who appeared to be similar at baseline, similar incontinence cures and improvements were made for robotic-assisted and conventional open BC at 6 months. When treating SUI surgically with robotic-assisted hysterectomy, adding robotic BC seems to be a better approach than performing midurethral sling procedures. ( J GYNECOL SURG 32:119)

Robotic-assisted benign hysterectomy compared with laparoscopic, vaginal, and open surgery: a systematic review and meta-analysis

“…5e). The overall pooled analysis (three database studies [22,30,39] and one prospective study [38]) showed a lower risk of mortality with the robotic group (OR: 0.12 [0.05, 0.29], I 2 = 26%, p < 0.00001, Fig. 5f).…”

“…5b), but the subgroup analysis of prospective comparison studies was not significant. The individual meta-analyses of two prospective studies [34,38] and four database studies [16,24,28,30] reporter a shorter LOS favoring the robotic approach (MD: -1.65 days [-2.33, -0.96], I 2 = 95%, p < 0.00001 and MD: -1.14 days 1.85, -0.43], I 2 = 100%, p = 0.002, respectively, Fig. 5c) as did the overall pooled analysis (MD: -1.31 [-1.88, -0.74], I 2 = 100%, p < 0.00001).…”

“…5d). The meta-analyses of two prospective studies [34,38] and the overall pooled analysis showed a lower EBL with the robotic approach versus the open approach (MD: -81.45 mL [-118.71, -44.20], I 2 = 50%, p < 0.0001, MD: -123.01 [-214.83, -31.19], I 2 = 99%, p = 0.009 respectively, Fig. 5e).…”