Outcomes of Robotic Urethropexy and Mid-urethral Sling Using a Single Center ACQUIRE Database

Objectives: Comparison of surgical outcomes of robotic assisted urethropexy (Burch) and mid-urethral sling registered in ACQUIRE database at University of Texas Medical Branch.

Methods: All patients were recruited in our institution during the American Urogynecology Quality Registry (ACQUIRE) data base collection. Our cohort consists of patients undergoing Burch (n =19) and Sling (n = 33) procedures. All Burch procedures were performed using robotic assisted technique. Tension-free Vaginal Tape was used in all mid-urethral sling procedures. Statistical analysis was conducted with a 1-Factor GLM, ANOVA, accounting for balanced data. Data log transformed when needed to reach reliable conclusions from the analysis that now met the assumptions of equal variance and normality.

Results: There was no statistically significant difference found in the two cohorts for age, race, ethnicity, parity, BMI, smoking, IDDM, prior hysterectomy, and prior abdominal pelvic surgery (Table 1). Comparison of length of stay after incontinence surgery alone yielded significant difference of 21.2 minutes between two groups (Burch; Sling: 1.90hrs; 1.69hrs respectively, p = 0.03). Intraoperative estimated blood loss was 43cc for Burch and 29 cc for Sling procedure (p = 0.53). One or more episodes of post-op UTI during 6-weeks postop follow-up, was clinically diagnosed in 4 patients after Burch and 14 patients subsequent Sling procedure (p = 0.12). Mesh exposure was observed in two cases after Sling procedure. Post-operative urinary retention observed in two patients for mid-urethral sling arm and no urinary retention was observed after Burch procedure.

Conclusions: Comparison of the robotic Burch procedure to mid-urethral sling there is no statistical difference in post-operative UTI, blood loss, and urinary retention rate. Length of stay differed statistically in favor of mid-urethral sling; however, this was not clinically meaningful.