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

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 patien...

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Autores principales: Martoccia, Alessia, Al Salhi, Yazan, Fuschi, Andrea, Rera, Onofrio Antonio, Suraci, Paolo Pietro, Scalzo, Silvio, Antonioni, Alice, Valenzi, Fabio Maria, Sequi, Manfredi Bruno, De Nunzio, Cosimo, Lombardo, Riccardo, Sciarra, Alessandro, Di Pierro, Giovanni, Bozzini, Giorgio, Asimakopoulos, Anastasios D., Finazzi Agrò, Enrico, Zucchi, Alessandro, Gubiotti, Marilena, Cervigni, Mauro, Carbone, Antonio, Pastore, Antonio Luigi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10452351/
https://www.ncbi.nlm.nih.gov/pubmed/37626605
http://dx.doi.org/10.3390/biomedicines11082105
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author Martoccia, Alessia
Al Salhi, Yazan
Fuschi, Andrea
Rera, Onofrio Antonio
Suraci, Paolo Pietro
Scalzo, Silvio
Antonioni, Alice
Valenzi, Fabio Maria
Sequi, Manfredi Bruno
De Nunzio, Cosimo
Lombardo, Riccardo
Sciarra, Alessandro
Di Pierro, Giovanni
Bozzini, Giorgio
Asimakopoulos, Anastasios D.
Finazzi Agrò, Enrico
Zucchi, Alessandro
Gubiotti, Marilena
Cervigni, Mauro
Carbone, Antonio
Pastore, Antonio Luigi
author_facet Martoccia, Alessia
Al Salhi, Yazan
Fuschi, Andrea
Rera, Onofrio Antonio
Suraci, Paolo Pietro
Scalzo, Silvio
Antonioni, Alice
Valenzi, Fabio Maria
Sequi, Manfredi Bruno
De Nunzio, Cosimo
Lombardo, Riccardo
Sciarra, Alessandro
Di Pierro, Giovanni
Bozzini, Giorgio
Asimakopoulos, Anastasios D.
Finazzi Agrò, Enrico
Zucchi, Alessandro
Gubiotti, Marilena
Cervigni, Mauro
Carbone, Antonio
Pastore, Antonio Luigi
author_sort Martoccia, Alessia
collection PubMed
description 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.
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spelling pubmed-104523512023-08-26 Robot-Assisted Sacrocolpopexy versus Trans-Vaginal Multicompartment Prolapse Repair: Impact on Lower Bowel Tract Function Martoccia, Alessia Al Salhi, Yazan Fuschi, Andrea Rera, Onofrio Antonio Suraci, Paolo Pietro Scalzo, Silvio Antonioni, Alice Valenzi, Fabio Maria Sequi, Manfredi Bruno De Nunzio, Cosimo Lombardo, Riccardo Sciarra, Alessandro Di Pierro, Giovanni Bozzini, Giorgio Asimakopoulos, Anastasios D. Finazzi Agrò, Enrico Zucchi, Alessandro Gubiotti, Marilena Cervigni, Mauro Carbone, Antonio Pastore, Antonio Luigi Biomedicines Article 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. MDPI 2023-07-26 /pmc/articles/PMC10452351/ /pubmed/37626605 http://dx.doi.org/10.3390/biomedicines11082105 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Martoccia, Alessia
Al Salhi, Yazan
Fuschi, Andrea
Rera, Onofrio Antonio
Suraci, Paolo Pietro
Scalzo, Silvio
Antonioni, Alice
Valenzi, Fabio Maria
Sequi, Manfredi Bruno
De Nunzio, Cosimo
Lombardo, Riccardo
Sciarra, Alessandro
Di Pierro, Giovanni
Bozzini, Giorgio
Asimakopoulos, Anastasios D.
Finazzi Agrò, Enrico
Zucchi, Alessandro
Gubiotti, Marilena
Cervigni, Mauro
Carbone, Antonio
Pastore, Antonio Luigi
Robot-Assisted Sacrocolpopexy versus Trans-Vaginal Multicompartment Prolapse Repair: Impact on Lower Bowel Tract Function
title Robot-Assisted Sacrocolpopexy versus Trans-Vaginal Multicompartment Prolapse Repair: Impact on Lower Bowel Tract Function
title_full Robot-Assisted Sacrocolpopexy versus Trans-Vaginal Multicompartment Prolapse Repair: Impact on Lower Bowel Tract Function
title_fullStr Robot-Assisted Sacrocolpopexy versus Trans-Vaginal Multicompartment Prolapse Repair: Impact on Lower Bowel Tract Function
title_full_unstemmed Robot-Assisted Sacrocolpopexy versus Trans-Vaginal Multicompartment Prolapse Repair: Impact on Lower Bowel Tract Function
title_short Robot-Assisted Sacrocolpopexy versus Trans-Vaginal Multicompartment Prolapse Repair: Impact on Lower Bowel Tract Function
title_sort robot-assisted sacrocolpopexy versus trans-vaginal multicompartment prolapse repair: impact on lower bowel tract function
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10452351/
https://www.ncbi.nlm.nih.gov/pubmed/37626605
http://dx.doi.org/10.3390/biomedicines11082105
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