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Minimally Invasive Approaches in the Treatment of Pelvic Organ Prolapse: Laparoscopic and Robotic

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Female Genitourinary and Pelvic Floor Reconstruction

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Abstract

Pelvic organ prolapse is a common disease process in women as the descent of the pelvic organs is a multifactorial process. Approximately 40% of women have some degree of prolapse on exam. However, when examined by degree of bother, the prevalence of symptomatic prolapse is less – ranging from 3% to 6% of parous women. For women who are symptomatic and bothered by prolapse, the treatment options are conservative management, pelvic floor physical therapy, pessary use, and surgery. Surgery for prolapse has remained an important option for women to restore pelvic anatomy, improve prolapse symptoms, and maintain quality of life. With the advancement of minimally invasive surgical techniques, the morbidity of pelvic organ prolapse surgery has decreased. Minimally invasive surgery (MIS) approaches have revolutionized and advanced contemporary pelvic organ prolapse surgery. Minimally invasive prolapse surgeries, both laparoscopic and robotic-assisted laparoscopic, have benefited women by facilitating apical support through smaller incisions and with improved visualization. With the advancement of minimally invasive surgical techniques, the morbidity of pelvic organ prolapse surgery has decreased. Surgery for prolapse has remained an important option for women to restore pelvic anatomy, improve prolapse symptoms, and maintain quality of life.

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Abbreviations

ASC:

Open abdominal sacrocolpopexy

ATFP:

Arcus tendineus fascia pelvis

ERAS:

Enhanced recovery after surgery

FDA:

Food and Drug Administration

LSC:

Laparoscopic sacrocolpopexy

MIS:

Minimally invasive surgery

POP:

Pelvic organ prolapse

POP-Q:

POP quantification

RSC:

Robotic-assisted sacrocolpopexy

SDD:

Same-day discharge

TLH-USLS:

Total laparoscopic hysterectomy

TVH-USLS:

USLS and total vaginal hysterectomy

US:

United States

USLS:

Uterosacral ligament suspension

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Authors and Affiliations

  1. Section of Urology and Renal Transplantation, Virginia Mason Franciscan Health, Seattle, WA, USA

    Justina Tam & Una J. Lee

  2. Department of Urology, University of California Irvine, Irvine, CA, USA

    Dena E. Moskowitz

  3. Department of Urology, University of Miami Miller School of Medicine, Miami, FL, USA

    Katherine A. Amin

  4. Urogynecology, Stony Brook Medicine, Stony Brook, NY, USA

    Justina Tam

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  1. Justina Tam
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  2. Dena E. Moskowitz
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  3. Katherine A. Amin
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  4. Una J. Lee
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Corresponding author

Correspondence to Una J. Lee .

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Editors and Affiliations

  1. University of Lisbon, Lisbon, Portugal

    Francisco E. Martins

  2. University of Oslo, Oslo, Norway

    Henriette Veiby Holm

  3. Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Jaspreet S. Sandhu

  4. Eastern Virginia Medical School, Norfolk, VA, USA

    Kurt A McCammon

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Tam, J., Moskowitz, D.E., Amin, K.A., Lee, U.J. (2023). Minimally Invasive Approaches in the Treatment of Pelvic Organ Prolapse: Laparoscopic and Robotic. In: Martins, F.E., Holm, H.V., Sandhu, J.S., McCammon, K.A. (eds) Female Genitourinary and Pelvic Floor Reconstruction. Springer, Cham. https://doi.org/10.1007/978-3-031-19598-3_32

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