E-Posters-10194

10194_Bradley

Pdf Summary

The study aimed to determine whether surgical correction of an enlarged pre-operative genital hiatus (GH) would impact anatomic failure after robotic-assisted laparoscopic sacrocolpopexy. The study included women who underwent robotic-assisted abdominal sacrocolpopexy from January 2013 to September 2016 and were stratified based on pre- and post-op GH size. The primary outcome was composite anatomic failure, defined as recurrent prolapse in any compartment or retreatment for prolapse with either surgery or pessary.<br /><br />The study population consisted of 452 women with a mean age of 59.3. The groups were distributed as follows: 12.6% were persistently wide GH, 65.5% were improved GH, and 21.9% were stably normal GH. The stably normal group had less advanced preoperative prolapse than the other groups. <br /><br />The study found a statistically significant difference in overall composite anatomic failure between the groups. In a logistic regression model, there was a higher odds of composite anatomic failure in the persistently wide group compared to the improved group and the stably normal group. There was no difference in reoperation among groups.<br /><br />The study concluded that surgical reduction of a wide pre-operative GH to a normal GH decreases composite anatomic failure, specifically related to the posterior compartment. The study suggests conducting further studies to determine the correlation of intraoperative measurement of GH to postoperative GH and to help clinicians determine who may benefit from a concomitant posterior repair/perineoplasty.<br /><br />Overall, the findings highlight the importance of addressing pre-operative GH size in surgical interventions for pelvic organ prolapse and provide valuable insights for improving patient outcomes.

Keywords

surgical correction

genital hiatus

laparoscopic sacrocolpopexy

anatomic failure

prolapse

preoperative prolapse

posterior compartment

intraoperative measurement

reoperation

patient outcomes