To evaluate the long-term functional and quality of life (QoL) outcomes of mesh robotic-assisted sacrocolpopexy (RASC) for pelvic organ prolapse (POP) with a minimum follow-up period of five years, and up to ten years.

This retrospective study analysed prospectively collected data from 20 patients who underwent RASC for POP at a single centre from September 2014 to 2018. Inclusion criteria included a diagnosis of POP requiring surgical intervention, undergoing RASC performed by the same surgeon, and a minimum follow-up period of five years. Data collected included demographic variables, preoperative and postoperative functional evaluations using the Pelvic Floor Impact Questionnaire (PFIQ), perioperative data, and Patient Global Impression of Improvement (PGI-I) scores. Statistical significance of preoperative and postoperative PFIQ scores was assessed using the Wilcoxon signed-rank test.

The mean age of patients was 65 years. Forty percent (n=8) had undergone a previous hysterectomy, 25% (n=5) had a history of prior surgery for lower urinary tract symptoms (LUTS), and 25% (n=5) experienced a recurrence of POP following previous transvaginal prolapse repair surgery. The average operative time was 142 minutes, with a mean estimated blood loss of 100 milliliters. No major complications were reported within 30 days post-surgery. Significant improvements were observed in PFIQ scores across all domains: ‘bladder or urine' symptom scores decreased from 19.04 to 4.05, ‘bowel or rectum' symptom scores from 25.50 to 4.99, and ‘vaginal or pelvic' symptom scores from 20.24 to 3.10 (p < 0.001 for all). 90% (n=18) of patients reported their symptoms as very much better, much better or a little better according to PGI-I scores.

RASC is an effective and safe procedure for treating POP, offering substantial improvements in functional outcomes and QoL with low complication and recurrence rates. This represents the first study on mesh RASC originating from a urological unit in Australia. It supports RASC as a preferred surgical option for POP, demonstrating its viability in the medium to long term of five to ten years and indicating encouraging results for longer-term outcomes. Future research should focus on larger, multicentre studies with extended follow-up periods to further elucidate the benefits and potential risks associated with this advanced surgical technique.