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

Autor:	Martoccia A; Urology Unit, Department of Medical-Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, 'Sapienza' University of Rome, 04100 Latina, Italy., Al Salhi Y; Urology Unit, Department of Medical-Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, 'Sapienza' University of Rome, 04100 Latina, Italy., Fuschi A; Urology Unit, Department of Medical-Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, 'Sapienza' University of Rome, 04100 Latina, Italy., Rera OA; Urology Unit, Department of Medical-Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, 'Sapienza' University of Rome, 04100 Latina, Italy., Suraci PP; Urology Unit, Department of Medical-Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, 'Sapienza' University of Rome, 04100 Latina, Italy., Scalzo S; Urology Unit, Department of Medical-Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, 'Sapienza' University of Rome, 04100 Latina, Italy., Antonioni A; Urology Unit, Department of Medical-Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, 'Sapienza' University of Rome, 04100 Latina, Italy., Valenzi FM; Urology Unit, Department of Medical-Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, 'Sapienza' University of Rome, 04100 Latina, Italy., Sequi MB; Urology Unit, Department of Medical-Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, 'Sapienza' University of Rome, 04100 Latina, Italy., De Nunzio C; Department of Urology, Sant'Andrea Hospital, Sapienza University of Rome, 00189 Rome, Italy., Lombardo R; Department of Urology, Sant'Andrea Hospital, Sapienza University of Rome, 00189 Rome, Italy., Sciarra A; Policlinico Umberto I, Department of Urology, Sapienza University of Rome, 00161 Rome, Italy., Di Pierro G; Policlinico Umberto I, Department of Urology, Sapienza University of Rome, 00161 Rome, Italy., Bozzini G; Department of Urology, ASST Lariana-Sant'Anna Hospital, 22100 Como, Italy., Asimakopoulos AD; Urology Unit, Fondazione PTV Policlinico Tor Vergata University Hospital, 00133 Rome, Italy., Finazzi Agrò E; Urology Unit, Fondazione PTV Policlinico Tor Vergata University Hospital, 00133 Rome, Italy., Zucchi A; Department of Urology, University of Pisa, 56126 Pisa, Italy., Gubiotti M; Department of Urology, San Donato Hospital, 52100 Arezzo, Italy., Cervigni M; Urology Unit, Department of Medical-Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, 'Sapienza' University of Rome, 04100 Latina, Italy., Carbone A; Urology Unit, Department of Medical-Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, 'Sapienza' University of Rome, 04100 Latina, Italy., Pastore AL; Urology Unit, Department of Medical-Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, 'Sapienza' University of Rome, 04100 Latina, Italy.
Jazyk:	angličtina
Zdroj:	Biomedicines [Biomedicines] 2023 Jul 26; Vol. 11 (8). Date of Electronic Publication: 2023 Jul 26.
DOI:	10.3390/biomedicines11082105
Abstrakt:	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.
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu