Short-Term Functional Outcomes After Robot-Assisted Sacrocolpopexy versus Transvaginal Mesh Surgery for Pelvic Organ Prolapse: A Retrospective Comparative Study.

Purpose: This study aimed to compare lower urinary tract symptoms (LUTS) in women with pelvic organ prolapse (POP) undergoing robot-assisted sacrocolpopexy (RSC) or transvaginal mesh surgery (TVM). Methods: A retrospective analysis was conducted on patients who underwent RSC or TVM at our institution between August 2017 and December 2024. Patient demographics, surgical records, and questionnaire responses were collected. LUTS were evaluated using the Overactive Bladder Symptom Score (OABSS), International Prostate Symptom Score (IPSS), and Quality of Life (QOL) score. Preoperative and 1-month postoperative questionnaire responses were compared within each group using the Mann-Whitney U-test. Intergroup comparisons were performed after adjusting for baseline differences through propensity score matching, and their significance was analyzed using the Wilcoxon rank-sum test. Results: A total of 51 patients underwent RSC and 21 underwent TVM. No significant differences were observed in age, body mass index, or Pelvic Organ Prolapse Quantification stage between the groups. The RSC group had a longer operative time (273 vs 127 minutes, p < 0.01) and less blood loss (10.0 vs 150 mL, p < 0.01). Both groups showed significant improvements in IPSS and QOL scores, whereas the OABSS did not change significantly. The RSC group had a significantly lower postoperative QOL score compared with the TVM group, but no significant differences were found after propensity score matching. No significant differences were observed between the groups in either the absolute changes or relative reductions of LUTS questionnaire scores. The incidence of de novo stress urinary incontinence was similar between the groups. Conclusion: Both RSC and TVM effectively improved LUTS in women with POP. After adjusting for baseline differences, no significant differences in postoperative voiding symptoms were observed between the two procedures. These findings support flexible surgical decision-making based on patient characteristics, perioperative risks, surgeon experience, and shared decision-making.