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Vaginal Versus Supracervical Hysterectomies With Concomitant Robotic Sacrocolpopexy

A Comparison of Outcomes [27A]

Adegoke, Oluwakemi A., MD; Hines, Brian, MD; Sandhu, Katherine S., MD

Obstetrics & Gynecology: May 2016 - Volume 127 - Issue - p 18S
doi: 10.1097/01.AOG.0000483319.57756.48
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INTRODUCTION: Robotic sacrocolpopexy is considered an effective treatment for women with profound apical pelvic floor prolapse. At our institution, robotic sacrocolpopexy was traditionally achieved by performing a supracervical hysterectomy and utilizing the power morcellator. With growing concerns of the safety of the power morcellator, physicians abandoned this tool and developed another method of performing the robotic sacrocolpopexy by utilizing a vaginal hysterectomy. Our primary objective is to compare vaginal and supracervical hysterectomies with concomitant robotic sacrocolpopexies with regards to perioperative complications and short term morbidity.

METHODS: This was a retrospective chart review of women who underwent robotic sacrocolpopexies between January 2013 to December 2014 at The Stamford Hospital. One-way ANOVA, proportion odds model, and Repeated-Measures Logistic Regression Model were used to analyze data collected.

RESULTS: A total of 57 sacrocolpopexies were performed between January 2013 to December 2014 at Stamford Hospital. 12 women were excluded from the study due to prior hysterectomies. Patients that had a supracervical hysterectomy were associated with a 0.123 times decrease in odds of having (immediate) Post-Op Pain [95% confidence interval, 0.022 to 0.694]. However, patients that had a supracervical hysterectomy were associated with a 4.3323 times increased odds of being in pain [95% confidence interval, 1.1412 to 16.4463] during the 2-Week/6-Week/follow-up period.

CONCLUSION: Postoperative pain is associated with type of surgical procedure conducted. However, vaginal hysterectomy associated with sacrocolpopexy appears to be a safe and reasonable alternative to the supracervical hysterectomy with concomitant sacrocolpopexy. Further research is needed to determine long term differences in complications and effectiveness.

Stamford Hosp/Columbia Univ, Stamford, CT

Financial Disclosure: The authors did not report any potential conflicts of interest.

© 2016 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.