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Robot-Assisted Sacrocolpopexy versus Trans-Vaginal Multicompartment Prolapse Repair: Impact on Lower Bowel Tract Function

Authors :
Alessia Martoccia
Yazan Al Salhi
Andrea Fuschi
Onofrio Antonio Rera
Paolo Pietro Suraci
Silvio Scalzo
Alice Antonioni
Fabio Maria Valenzi
Manfredi Bruno Sequi
Cosimo De Nunzio
Riccardo Lombardo
Alessandro Sciarra
Giovanni Di Pierro
Giorgio Bozzini
Anastasios D. Asimakopoulos
Enrico Finazzi Agrò
Alessandro Zucchi
Marilena Gubiotti
Mauro Cervigni
Antonio Carbone
Antonio Luigi Pastore
Source :
Biomedicines, Vol 11, Iss 8, p 2105 (2023)
Publication Year :
2023
Publisher :
MDPI AG, 2023.

Abstract

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: 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: 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 (p < 0.05) in postoperative anal sphincter tone: 35%. The TVMLP group experienced a hypertonic anal sphincter, while none of the RSC group did. Regarding subjective improvement, the median PGI-I was 1 in both groups. At 12 months of follow-up, both groups exhibited a significant improvement in bowel symptoms. Conclusions: RSC and TVMLP successfully corrected multicompartment POP. RSC showed a greater improvement in the total Agachan–Wexner score and lower bowel symptoms.

Details

Language :
English
ISSN :
22279059
Volume :
11
Issue :
8
Database :
Directory of Open Access Journals
Journal :
Biomedicines
Publication Type :
Academic Journal
Accession number :
edsdoj.5778909a448f4a87bb87c97324197065
Document Type :
article
Full Text :
https://doi.org/10.3390/biomedicines11082105