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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...
Autores principales: | , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
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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. |
format | Online Article Text |
id | pubmed-10452351 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
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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