eP623 - Long Term Functional and Quality of Life Outcomes Following Combined Robotic Ventral Mesh Rectopexy and Sacrocolpopexy

Purpose/Background: Pelvic floor dysfunction has increased in prevalence. Many patients suffer from multicompartmental prolapse. As alteration of a single compartment can negatively affect the other, a multidisciplinary approach to treatment is warranted. We previously demonstrated the safety and effectiveness of combined robotic pelvic floor reconstruction and previously reported our 30-day post-operative outcomes. Limited data exists regarding the long-term functional and quality of life outcomes following combined robotic pelvic floor reconstruction.Methods/Interventions: We performed a multi-hospital single institutional retrospective review and questionnaire study of patients undergoing combined robotic ventral mesh rectopexy and sacrocolpopexy for multicompartmental pelvic organ prolapse from March 2018 to January 2022. A questionnaire focusing on obstructive defecation, fecal incontinence, along with quality of life was used. The Wexner fecal incontinence score along with the obstructive defection syndrome score (ODS-S) were used. The aim of this study was to assess the long-term functional outcomes following combined robotic repair.Results/Outcomes: 287 patients underwent combined pelvic floor reconstruction. 2 (0.7%) patients had recurrent rectal prolapse and 6 (2.1%) had post-operative complications requiring reoperation; these were excluded from analysis. 279 patients were evaluated for long term outcomes. The mean age was 63 years, and body mass index (BMI) 27.6 with a mean follow up of 2.65 years. The following were indications for repair: 35.8% rectal prolapse, 73.8% rectocele, and 4.6% abnormal pelvic descent. 66.3% of patients had preoperative constipation and 45.5% fecal incontinence. Following repair: 30.3% patients had fecal incontinence with an average Wexner score of 8.7. 10.6% of patients experienced new fecal incontinence. ODS-S 7.4. 13.6% patients reported new constipation. 77.3% patients said they would have surgery again, and 71.2% reported greater than 50% improvement in quality of life.Conclusion/

Discussion: Multidisciplinary combined robotic pelvic floor reconstruction for multicompartmental pelvic organ prolapse has long lasting durability with significant improvement in quality of life and should be considered for all patients with pelvic floor dysfunction.