PD24-05 POST-OPERATIVE OUTCOMES AFTER ROBOTIC-ASSISTED PELVIC MESH REMOVAL

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Female Pelvic Organ Prolapse and Reconstructive Surgery (Including Non-trauma Related Fistula and Urethral Diverticulum) (PD24)1 May 2024PD24-05 POST-OPERATIVE OUTCOMES AFTER ROBOTIC-ASSISTED PELVIC MESH REMOVAL Frances C. W. Harley, Eva Fong, Henry Yao, and Helen E. O'Connell Frances C. W. HarleyFrances C. W. Harley , Eva FongEva Fong , Henry YaoHenry Yao , and Helen E. O'ConnellHelen E. O'Connell View All Author Informationhttps://doi.org/10.1097/01.JU.0001008840.07763.8d.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Stress urinary incontinence (SUI) and pelvic organ prolapse (POP) are widespread conditions that significantly affect the quality of life for women globally. It's essential to note that women face an estimated 11% lifetime risk of requiring surgery for either SUI or POP, with a specific lifetime risk of 30-50% for POP. The ban on Transvaginal Mesh (TVM), introduced in the early 2000s to mitigate the high failure rates in POP repairs using native tissue, is attributed to its frequent complications. Dealing with these complications is a multifaceted and intricate process, often involving the removal of the mesh product. The advantages of enhanced access and vision provided by robotic-assisted surgery may prove beneficial for this intricate procedure, potentially resulting in equivalent or improved patient outcomes. The primary outcome is the patient-reported outcome rate of symptoms by PGI-I for pelvic pain and urinary incontinence at the 12-month follow-up. METHODS: This multicenter prospective case series study focused on women aged 18 and older who underwent robot-assisted pelvic mesh removal via transabdominal or transvaginal methods. Operative data was collected, categorizing mesh removal (partial or complete), documenting concomitant procedures, and recording surgical complications. Patient-reported outcome measures were completed at 30 days and approximately 12 months postoperatively to assess the impact on incontinence symptoms and pelvic pain compared to the pre-operative condition. RESULTS: In this study, there were 39 participants with a median age of 64 years. Among them, 77% underwent complete mesh removal, 15% near complete removal, and 8% had partial removal. Approximately one-third of patients underwent concomitant procedures.Post-operatively, 62% of patients experienced improvement in their urinary symptoms and leakage, while 76% reported improved pelvic pain symptoms. However, 63% still reported ongoing pain or discomfort. Interestingly, 50% of patients continued to require analgesia after the procedure, and 42% encountered ongoing difficulties with bladder emptying following the surgery. CONCLUSIONS: By employing a robotically assisted approach, this study represents the most extensive cohort of patients reporting long-term outcomes after pelvic mesh removal. Beyond merely alleviating initial symptoms, this approach has demonstrated its safety and effectiveness in substantially reducing the recurrence rates of urinary leakage. Source of Funding: Australian Commonwealth Government through a Australian Government Research Training Program Scholarship © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e532 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Frances C. W. Harley More articles by this author Eva Fong More articles by this author Henry Yao More articles by this author Helen E. O'Connell More articles by this author Expand All Advertisement PDF downloadLoading ...