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The Use of Robotic Technology in Female Pelvic Floor Reconstruction pp 21–35Cite as

Selection of Concomitant Vaginal Procedures

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Abstract

Robotic sacrocolpopexy (RASC) is a minimally invasive abdominal apical suspension procedure for women with pelvic organ prolapse (POP); however, there is controversy and a diversity of expert opinions as to the best management of defects in other vaginal compartments at the time of RASC, as the coexistence of multiple defects is common. Some surgeons feel that the apical support of RASC alone is adequate to restore anatomy and resolve prolapse and associated urinary, defecatory, and sexual symptoms. Some advocate a technique of distal anchoring of the sacrocolpopexy mesh to achieve this restoration. Other surgeons routinely perform concomitant vaginal repairs to address anterior and/or posterior compartment prolapse. There are few, if any, comparative studies of these approaches to evaluate success, recurrence, or impact on associated symptomatology. Existing observational evidence of both approaches and impact on outcomes is reviewed. The pelvic floor surgeon may utilize available data as an aid in discussing patient goals of treatment and surgical options for concomitant vaginal procedures, including risks and benefits of various approaches, to reach a shared decision with the patient.

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Authors and Affiliations

  1. Section of Urology and Renal Transplantation, Virginia Mason, 1100 9th Avenue, C7-URO, Seattle, Washington, USA

    Sarah A. Adelstein M.D. & Una J. Lee M.D.

Authors
  1. Sarah A. Adelstein M.D.
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  2. Una J. Lee M.D.
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Correspondence to Una J. Lee M.D. .

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Editors and Affiliations

  1. Department of Surgery, Division of Urology, Cedars-Sinai Medical Center, Beverly Hills, California, USA

    Jennifer T. Anger

  2. Department of Surgery, Division of Urology, Cedars-Sinai Medical Center, Beverly Hills, California, USA

    Karyn S. Eilber

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Adelstein, S.A., Lee, U.J. (2018). Selection of Concomitant Vaginal Procedures. In: Anger, J., Eilber, K. (eds) The Use of Robotic Technology in Female Pelvic Floor Reconstruction . Springer, Cham. https://doi.org/10.1007/978-3-319-59611-2_3

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  • DOI: https://doi.org/10.1007/978-3-319-59611-2_3

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