Robot-assisted Sacrocolpopexy Efficacy and Safety for Lower Urinary Tract Dysfunction Associated With Pelvic Organ Prolapse

Background/Aim: Pelvic organ prolapse (POP) is a condition in which the bladder, uterus, or rectum prolapses from the vagina. Assessing the presence or absence of POP is important when examining for lower urinary tract dysfunction (LUTD) in women. However, reports on changes in LUTD before and after robot-assisted sacrocolpopexy (RSC) are scarce. This study aimed to explore the progression of LUTD after RSC for POP. Patients and Methods: Patients with POP who underwent RSC at the Department of Urology, Nara Medical University, between July 1, 2021, and September 30, 2024, were enrolled. Patient background, perioperative uroflowmetry results, treatment efficacy, and safety were retrospectively evaluated. Results: In total, 23 patients were included in the study, with a median age of 74.0 years at the time of surgery. The total international prostate symptom score and quality of life scores were significantly lower at 4 weeks after surgery than at baseline and continued to decrease at 12 and 24 weeks. The maximum flow rate was significantly higher at 4 weeks after surgery than at baseline and continued to increase at 12 and 24 weeks. The post-void residual urine volume was significantly lower at 4 weeks after surgery than at baseline and continued to decrease at 12 and 24 weeks. Postoperative complications included urinary incontinence (grade II and IIIb) in two patients and intestinal obstruction (grade IIIb) in one patient. Two cases of stage II recurrence were identified, but after consultation with the patients, no reoperation was performed. Conclusion: RSC appears to be a clinically useful option for pelvic organ prolapse with concomitant lower urinary tract dysfunction, providing meaningful postoperative functional improvement with an acceptable safety profile. Larger comparative studies with longer follow up are needed to confirm durability and better define patient selection and complication prevention.