Introduction

The present randomized study compares Laparoscopic sacropexy (LSC) and Robotic assisted sacropexy (RASC) in women with advanced pelvic organ prolapse (POP) to demonstrate the equivalence between the two techniques

Methods

Consecutive patients affected by symptomatic POP stage>II according to the POP-Q classification were prospectively randomized to test the clinical equivalence of RASC and LS. All women were preoperatively evaluated with history and physical examination. Urinary and sexual symptoms were assessed with the Urogenital Distress Inventory (UDI), the Incontinence Impact Questionnaire (IIQ-7) and the Female Sexual Function Index (FSFI) questionnaire. As primary outcome we evaluated the anatomical results considering as failure a POP>2 stage. Then we evaluated the difference between the two groups in terms of hospital stay length, blood loss, operating time, presence of voiding or storage symptoms and sexual function through the aforementioned questionnaires_x000D_

Results

To date 21 patients have been randomized to RASC and 19 to LSC. The mean follow-up was 23,36 months. No significant inter-group differences emerged in the pre-operative evaluations of age (mean 63.5 vs 58.82 yrs for RASC and LSC, p=0.06) and BMI (mean 24.59 vs 25.41 kg/m2 for RASC and LSC, p=0.55)._x000D_ The objective success rate was 81% for RASC vs 78,9% for LSC (p=0.6), 85% for RASC vs 63,2% for LSC (p=0.8) and 100% for RASC vs 94,7% for LSC (p=0.57) for cystocele, rectocele and point c/D repair respectively._x000D_ Although not significant, operating time was longer for LSC (mean 213 min for LSC vs 184 min for RASC, p=0.11) and intra-operative blood loss was higher in RASC (mean 32 ml for RASC vs 47 ml for LSC, p=0.46). No difference emerged in hospital stays (mean 3.8 days for LSC vs 3.9 days for RASC, p= 0.8). Functional results are reported in table 1. No major complications were detected, only 2 grade III complication according to Clavien-Dindo classification has been reported in the LSC group (1 bladder injury and 1 mesh exposure). The subjective success rate was very high, 100% of patients of both groups reported to be “much” and “very much” improved at the PGI-I questionnaire

Conclusions

RASC aims at providing a similar excellent outcome as LSC in terms of anatomical results, satisfaction rate, complications, sexual function and voiding and storage symptoms relief

Funding

none