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Short-Term Functional Outcomes After Robot-Assisted Sacrocolpopexy versus Transvaginal Mesh Surgery for Pelvic Organ
Kazushi Hanawa1,2, Yukie Miyashita3, Yoshito Usami1
1Department of Urology, Shizuoka Saiseikai General Hospital, Shizuoka, Japan.
Research and Reports in Urology
|November 28, 2025
Summary
Robot-assisted sacrocolpopexy (RSC) and transvaginal mesh (TVM) surgery both effectively treat lower urinary tract symptoms (LUTS) in women with pelvic organ prolapse (POP). Post-surgery, neither procedure showed significant differences in voiding symptom improvement after accounting for patient factors.
Area of Science:
- Urogynecology
- Minimally Invasive Surgery
- Pelvic Floor Disorders
Background:
- Pelvic organ prolapse (POP) frequently coexists with lower urinary tract symptoms (LUTS).
- Surgical management of POP aims to restore pelvic anatomy and alleviate associated symptoms.
- Robot-assisted sacrocolpopexy (RSC) and transvaginal mesh (TVM) are surgical options for POP, with varying impacts on LUTS.
Purpose of the Study:
- To compare the effectiveness of RSC versus TVM in improving LUTS in women with POP.
- To evaluate changes in Overactive Bladder Symptom Score (OABSS), International Prostate Symptom Score (IPSS), and Quality of Life (QOL) scores post-surgery.
Main Methods:
- Retrospective analysis of patients undergoing RSC or TVM between August 2017 and December 2024.
- LUTS assessment using OABSS, IPSS, and QOL questionnaires preoperatively and at 1-month postoperatively.
- Propensity score matching used for intergroup comparison to adjust for baseline differences.
Main Results:
- No significant baseline demographic or POP severity differences between the 51 RSC and 21 TVM patients.
- RSC involved longer operative time but less blood loss compared to TVM.
- Both procedures improved IPSS and QOL scores; OABSS showed no significant change. Postoperative QOL was similar after matching. De novo stress urinary incontinence incidence was comparable.
Conclusions:
- Both RSC and TVM are effective in improving LUTS in women with POP.
- No significant differences in postoperative voiding symptoms were found between RSC and TVM after adjusting for baseline characteristics.
- Surgical approach selection should be individualized based on patient factors and shared decision-making.
