Robotic Sacrocolpopexy With Versus Without Supracervical Hysterectomy.

UNLABELLED: INTRODUCTION AND HYPOTHESIS: After the age of 80, the cumulative incidence of surgery of pelvic organ prolapse (POP) exceeds 15%. While concomitant supracervical hysterectomy (SCH) is very popular at the time of sacrocolpopexy in some parts of the world, it is rarely performed in many European countries. The aim of the present study was to compare the outcomes of robotic sarcrocolpopexy with or without SCH.

METHODS

The charts of all consecutive patients who underwent minimally invasive sacrocolpopexy for POP at a single center between 2013 and 2023 were included in a retrospective study. The remaining patients were included for analysis and divided in two groups: with (HYST) vs. without (no HYST) supracervical hysterectomy.

RESULTS

Out of 197 minimally invasive sacrocolpopexy, 88 were included in the present analysis: 39 in the HYST group and 49 in the no-HYST group. The only statistically significant difference at baseline between the two groups was the higher proportion of grade 3 or 4 uterine prolapse in the HYST group (35.1% vs. 10.2%; p = 0.01). The postoperative complications rates were similar in both groups (16.7% vs. 18.4%; p = 0.84). After a median follow-up of 12 months, the subjective success rate was similar (96.6% vs. 92.2%; p = 0.44). Most outcomes were not significantly different.

CONCLUSIONS

In the present study, we did not demonstrate a benefit for SCH at the time of sacrocolpopexy. However, we did not observe an increased morbidity in the HYST group, suggesting that it may not exist anymore beyond the learning curve in the robotic era.