Sacrocolpopexy is generally considered the gold standard for treatment of apical pelvic organ prolapse. There is recent evidence showing that both laparoscopic and robotic sacrocolpopexies (LSC and RSC respectively) have comparable anatomic restoration and subjective cure rates as the open abdominal procedure. Quality of life in the areas of bladder, bowel, and sexual function are also shown to improve 1 year after a laparoscopic sacrocolpopexy. We decided to prospectively examine prolapse-related symptoms along with sexual and bowel functions post-LSC.

All patients scheduled for LSC with and without hysterectomy, anti- incontinence or other prolapse surgery were invited to complete a questionnaire booklet about their symptoms in relation to sexual, bowel function and general quality of life measures.  Operative details and POP-Q scores were recorded in theatre and the patient was discharged with another booklet to be completed prior to their 6 week follow-up appointment. An additional questionnaire booklet was mailed out to the patients at one-year after their surgery.

55 women completed the questionnaire and were included in the analysis.  The 6-week post-operative questionnaire was completed by 82% of the patients (45/55).  17 returned the 1-year post-operative questionnaire. In addition to quality of life questions, past surgical, medical and obstetric history was recorded, along with BMI.

25% of these 55 women had LSC only. 49% underwent a concurrent total laparoscopic hysterectomy. 27% also had laparoscopic Burch colposuspension, while 25% had other prolapse procedures including laparoscopic paravaginal repair and posterior repair/perineorraphy.

Paired-t tests on the pre and post-operative answers demonstrated a statistically significant improvement in feelings of prolapse and externally palpable prolapse (p-value <0.05), which is expected as that is the primary desired clinical effect of LSC. This effect persists at one-year post-operatively. General quality of life influenced by vaginal symptoms was also statistically significantly improved.

Improvements of larger magnitude that were statistically non-significant were sexual functions at 1-year. No statistically significant improvement or worsening in bowel function after LSC was demonstrated.

We conclude that at 1-year post-op, LSC does improve prolapse and general quality of life, whereas a bigger sample of patients may be required to show an improvement in sexual function. There is no deleterious effect on bowel functions after LSC, with no worsening of constipation. We aim to continue with the prospective collection of data on these areas of interest. As well, once robotic sacrocolpopexy cases are performed in the future, the questionnaires will be administered to help provide evidence on the effects of RSC on quality of life.