title: Robotic abdominal sacrocolpopexy/sacrouteropexy repair of advanced female pelvic organ prolaspe (POP): utilizing POP-quantification-based staging and outcomes.
abstract: OBJECTIVE
  To assess the management of advanced pelvic organ prolapse (POP) with robotic-assisted abdominal sacrocolpopexy (RASC) and evaluate outcomes using the POP quantification scale (POP-Q).
  
  
  METHODS
  Women with symptomatic stages III and IV POP were evaluated at our institution. After complete clinical assessment, including POP-Q-based physical examination and urodynamic studies, the patients underwent RASC with or without anti-incontinence surgery in the presence (sacrouteropexy) or absence of uterus (sacrocolpopexy). Follow-up examinations at 3 and 6 months included a POP-Q-based examination.
  
  
  RESULTS
  Fifteen women were consented for RASC; 12 underwent successful RASC, one required conversion to laparoscopic ASC, one to open ASC, and one to transvaginal repair. The mean (range) patient age was 64 (50-79) years. Before surgery, the mean POP-Q stage was 3.1 (3-4) and the POP-Q values for the anterior (Aa, Ba), posterior (Ap, Bp) and apex (C) of the vagina were: Aa - 0.9, Ba + 1.0, Ap - 1.0, Bp + 1.3, and C +2.1. After surgery, the mean POP-Q stage was 0 and the POP-Q values had improved to Aa - 2.29, Ba - 2.29, Ap - 2.65, Bp - 2.65, and C - 8.28. The mean (range) estimated blood loss during surgery was 81 (50-150) mL. The mean hospital stay was 2.4 (1-7) days. Seven patients had concurrent placement of a mid-urethral sling and one patient had a concurrent Burch colposuspension.
  
  
  CONCLUSIONS
  These early results show that RASC is safe and efficacious, and that its anatomical outcomes compare favourably to the reported results for open or laparoscopic ASC.
authors.affiliation: The Cleveland Clinic, Glickman Urological Institute, Cleveland, OH, USA.
authors.forename: Firouz
authors.initials: F
authors.lastname: Daneshgari
authors.forename: John C
authors.initials: JC
authors.lastname: Kefer
authors.forename: Courtenay
authors.initials: C
authors.lastname: Moore
authors.forename: Jihad
authors.initials: J
authors.lastname: Kaouk
mesh_terms: D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D011391:Prolapse; D012371:Robotics; D012720:Severity of Illness Index; D013524:Surgical Flaps; D013526:Surgical Mesh; D016896:Treatment Outcome; D013520:Urologic Surgical Procedures / Q000379:methods*; D014596:Uterine Prolapse / Q000601:surgery*