title: Differences in recurrent prolapse at 1 year after total vs supracervical hysterectomy and robotic sacrocolpopexy.
abstract: OBJECTIVE
  Optimal management of the cervix at the time of hysterectomy and sacrocolpopexy for primary uterovaginal prolapse is unknown. Our hypothesis was that recurrent prolapse at 1 year would be more likely after a supracervical robotic hysterectomy (SRH) compared with a total robotic hysterectomy (TRH) at the time of robotic sacrocolpopexy (RSCP) for uterovaginal prolapse.
  
  
  METHODS
  This was a retrospective cohort analysis of 83 women who underwent hysterectomy with RSCP over a 24-month period (40 with TRH and 43 with SRH). At 1 year post-procedure, subjects completed validated questionnaires regarding pelvic floor symptoms, sexual function, and global satisfaction, and underwent a pelvic examination to identify mesh exposure and evaluate pelvic floor support.
  
  
  RESULTS
  Demographics of the two groups were similar, except for a higher mean body mass index in the TRH group (31.9 TRH vs 25.8 SRH kg/m(2), p < 0.001). The rate of recurrent prolapse ≥ stage II was higher for women who underwent SRH compared with TRH (41.9 % vs 20.0 %, p = 0.03; OR 2.8, 95 % CI, 1.07-7.7). However, when this was analyzed as recurrence ≥ hymen, there was no difference between groups (12.5 % TRH vs 18.6 % SRH, p = 0.45). Likewise, there was no difference between groups when a composite measure of success was used (30 out of 40 [75 %] TRH vs 29 out of 43 [67.4 %] SRH, p = 0.45).
  
  
  CONCLUSIONS
  Women who underwent an SRH were 2.8 times more likely to have a recurrent prolapse, ≥ stage II, at 1 year, compared with those who underwent a TRH, but when composite assessment scores were used there was no difference between the groups.
authors.affiliation: Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, NC, USA, emyers07@gmail.com.
authors.forename: Erinn M
authors.initials: EM
authors.lastname: Myers
authors.forename: Lauren
authors.initials: L
authors.lastname: Siff
authors.forename: Blake
authors.initials: B
authors.lastname: Osmundsen
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Geller
authors.forename: Catherine A
authors.initials: CA
authors.lastname: Matthews
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures; D012447:Sacrum / Q000601:surgery; D013526:Surgical Mesh / Q000009:adverse effects; D011795:Surveys and Questionnaires; D013997:Time Factors; D014596:Uterine Prolapse / Q000601:surgery*; D014621:Vagina / Q000601:surgery