Long-term Outcomes After Robotic Assisted Sacrocolpopexy Using Barbed Delayed Absorbable Suture

Objectives: To evaluate the re-operation and long term patient reported outcomes in women undergoing robotic assisted sacrocolpopexy (RSC) using barbed delayed absorbable suture (BDAS).

Methods: This was an IRB-approved single institution retrospective cohort study on women that underwent RSC using 3/0 BDAS for their pelvic organ prolapse from January 2016 to December 2018. Patients who had undergone this procedure during this time frame were recruited for a telephone interview to assess reoperation and subjective outcomes. The following validated questionnaires were used: Patient Global Impression of Improvement (PGI-I), Decision Regret Scale (DRS), and Satisfaction with Decision Scale (SDS) and pelvic organ prolapse, urinary incontinence, and defecatory dysfunction symptoms measured by Pelvic Floor Distress Inventory-20 (PFDI-20).

Results: A total of 82 eligible subjects were identified. Out of these, thirty five women (42.6%) completed telephone interviews. Demographics and baseline characteristics are reported in Table 1. Three years after surgery, symptomatic prolapse recurrence required surgical intervention in 9 out of 82 patients (10.9%). The majority (7/9) of the re-operation procedures occurred between 6 months to 1 year after surgery. One case of repeat prolapse surgery occured within 6 months and another case between 1-2 years were observed. Patient’s satisfaction was excellent and pelvic floor function remained improved three years after the initial RSC according to the following measures: PGI-I with 80% reported their symptoms are better; DRS (1.78± 0.70); SDS (4.31±0.68); and PFDI-20 total score (66.2±63.7) with POPDI-6 subscale (23.1±24.7), CRAD-8 subscale (14.5±20.0), UDI-6 subscale (28.7±29.2).

Conclusions: The re-operation rate after RSC using 3/0 BDAS was consistent with previous studies examining RSC long-term outcomes using permanent or absorbable 2-0 polyglactin sutures (10% and 13% respectively). Our data showed excellent patient reported outcome measures. Currently, long-term outcomes for RSC using BDAS are limited, with no study reporting follow up greater than 1 year. Our study involving 3 year outcome data indicates that RSCP with BDAS has favorable long-term outcomes, with regard to both surgical re-operation and patient reported outcomes. The information plays important roles for preoperative patient counseling.