Mayo Clinic Researchers Find Robotic Repair for Vaginal Prolapse Has Significant Benefits

Vaginal prolapse is a condition in which structures such as the uterus, rectum, bladder, urethra, small bowel, or the vagina itself may begin to prolapse, or fall, from their normal positions. Without treatment or surgery, these structures may eventually prolapse farther into the vagina or even through the vaginal opening if their supports weaken enough."Vaginal prolapse is a common, yet distressing physical and cosmetic condition that 10-15 percent of women will suffer in their lifetimes," says Daniel Elliott, M.D., Mayo Clinic urologist and senior author on the study. "Robotic sacrocolpopexy surgery appears to offer many new benefits for patients — including decreased hospital stay and quicker recovery. Our study looked at longer-term results post-surgery to find out how patients fared."

From 2002 to 2008, 48 women with symptomatic high-grade post-hysterectomy vaginal vault prolapse underwent robotic sacrocolpopexy, or vaginal wall repair. Researchers monitored these patients for three years to evaluate the success rate of the procedure. Overall, researchers found better outcomes for robotic sacrocolpopexy patients than traditional surgery, which included: 1) less-invasive, laparoscopic surgery took less time in the operating room; 2) fewer postoperative complications; 3) shorter hospital stay; and 4) faster postoperative recovery and return to work or normal activities.

Prolapse often affects postmenopausal women who've had one or more vaginal deliveries. Damage sustained by supportive tissues during pregnancy and childbirth, plus the effects of gravity, loss of estrogen and repeated straining over the years, can weaken pelvic floor muscles and tissues and lead to uterine prolapse.

"Traditional abdominal sacrocolpopexy is a very durable procedure, but recovery is long and sometimes dissuades women from having surgery," says Dr. Elliott. "This new robotic surgery is a major improvement and offers more options for women who want to have their prolapse repaired and are looking for a less-invasive type of procedure."

Others on the Mayo research team include M.A. Childs, M.D., and George Chow, M.D..