Obstructed Defecation Syndrome: Analysis of the Efficacy and Mid-Term Quality of Life of an Innovative Robotic Approach
Abstract
1. Introduction
2. Materials and Methods
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Clinical Variables | VMR (30) | VMR + RP (33) | p |
---|---|---|---|
Mean Age (SD) | 62.34 (4.75) | 60.89 (4.09) | 0.21 |
Median Vaginal Delivery (range) | 2 (1–5) | 2 (1–4) | 0.67 |
Mean BMI (SD) | 27.34 (3.82) | 27.89 (4.03) | 0.21 |
Menopause Status (%) | 25 (83%) | 30 (90%) | 0.55 |
Smokers (%) | 4 (13%) | 6 (18%) | 0.45 |
Pelvic Organ Prolapse Stage (posterior compartment) | |||
Stage II (%) | 12 (40%) | 12 (36%) | 0.63 |
Stage III (%) | 12 (40%) | 15 (45%) | 0.23 |
Stage IV (%) | 6 (20%) | 6 (18%) | 0.78 |
Previous Surgical Procedure | |||
Hysterectomy (%) | 1(3%) | 1 (3%) | 0.34 |
Bilateral Adnexectomy (%) | 2 (6%) | 1 (3%) | 0.22 |
Shull Suspension (%) | 1 (3%) | 1 (3%) | 0.71 |
Abdominal Sacrocolpopexy (%) | 1 (3%) | 1 (3%) | 0.59 |
Anterior Colphorraphy (%) | 1 (3%) | 1 (3%) | 0.88 |
Posterior Colphorraphy (%) | 2 (6%) | 3 (9%) | 0.29 |
Continence Surgery (%) | 2 (6%) | 1 (3%) | 0.65 |
Complications | VMR (30) 1 Month | VMR (30) Median FU | VMR + RP (33) 1 Month | VMR + RP (33) Median FU | p |
---|---|---|---|---|---|
Rectal stenosis (%) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | ns |
Proctalgia, pain (%) | 1 (3.3) | 0 (0) | 2 (6) | 1 (3) | ns |
Obstructed defecation syndrome after surgery (%) | 1 (3.3) | 1 (3.3) | 1 (3) | 1 (3) | ns |
Tenesmus (%) | 0 (0) | 0 (0) | 1 (3) | 0 (0) | ns |
Post-defecatory soiling (%) | 1 (3.3) | 0 (0) | 1 (0) | 0 (0) | ns |
Dyspareunia (%) | 1 (3.3) | 0 (0) | 0 (0) | 0 (0) | ns |
Fecal Urgency (%) | 4 (13.3) | 1(3.3) | 2 (6) | 1 (3) | ns |
Constipation (%) | 12 (40) | 6 (20) | 2 (6) | 1 (3) | 0.023 |
Fecal Incontinence (%) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | ns |
Recto-Vaginal Fistula (%) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | ns |
Difficult voiding (%) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | ns |
Overactive Bladder (%) | 0 (0) | 0 (0) | 1 (3) | 0 (0) | ns |
Stress urinary incontinence (%) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | ns |
Urge urinary incontinence (%) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | ns |
Recurrent Urinary Tract Infections (%) | 1 (3.3) | 1 (3.3) | 1 (3) | 1 (3) | ns |
Variables | Preoperative VMR (30) | Median Follow-Up | p | Preoperative VMR + RP (33) | Median Follow-Up | p | VMR vs. VMR +RP |
---|---|---|---|---|---|---|---|
Posterior Compartment (Bp) | 1.52 ± 1.85 | 2.63 ± 0.34 | <0.001 | 1.48 ± 0.42 | −2.41 ± 0.64 | <0.001 | 0.45 |
Vaginal Digitation (%) | 21 (70) | 5 (16.6) | 0.034 | 23 (69.7) | 0 (0) | <0.001 | 0.041 |
Vaginal Bulge (%) | 25 (83.3) | 1 (3.3) | <0.001 | 25 (75.7) | 1 (3) | <0.001 | 0.76 |
P-QoL | 65.85 ± 17.12 | 32.03 ± 8.57 | 0.004 | 64.22 ± 16.23 | 27.54 ± 8.56 | < 0.001 | 0.54 |
PFDI-20 | 146.34 ± 65.27 | 41.76 ± 27.89 | <0.001 | 144.87 ± 63.88 | 38.87 ± 29.65 | <0.001 | 0.67 |
PFIQ-7 | 71.34 ± 54.87 | 12.76 ± 17.98 | <0.001 | 70.98 ± 53.79 | 11.74 ± 23.65 | <0.001 | 0.50 |
Sexual Activity (%) * | 12 (40) | 19 (63.3) | 0.047 | 11 (33.3) | 25 (75.7) | 0.007 | 0.033 |
PISQ-12 | 30.12 ± 7.12 | 35.98 ± 5.98 | 0.034 | 29.65 ± 6.45 | 29.65 ± 6.45 | < 0.001 | 0.041 |
Variables | VMR (30) | VMR +RP (33) | p |
---|---|---|---|
1: very much better | 21 (70%) | 24 (72%) | NS |
2: much better | 3 (10%) | 5 (15%) | NS |
3: a little better | 3 (10%) | 3 (9%) | NS |
4: no improvement | 3 (10%) | 1 (3%) | NS |
5: a little worse | 0 | 0 | NS |
6: much worse | 0 | 0 | NS |
7: very much worse | 0 | 0 | NS |
Success | 24 (80%) | 29 (87%) | NS |
Mean ODS Score | VMR 30 | VMR + RP 33 | p |
---|---|---|---|
Preoperative | 23.17 ± 4.82 | 22.23 ± 3.87 | 0.34 |
Postoperative | |||
6 mos | 6.31 ± 2.69 | 2.37 ± 1.59 | 0.11 |
12 mos | 5.11 ± 1.88 | 1.23 ± 1.14 | 0.03 |
18 mos | 7.22 ± 1.54 | 1.57 ± 1.14 | 0.02 |
Median follow up | 7.11 ± 1.65 | 1.88 ± 1.89 | 0.013 |
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Cervigni, M.; Fuschi, A.; Morciano, A.; Campanella, L.; Carbone, A.; Schiavi, M.C. Obstructed Defecation Syndrome: Analysis of the Efficacy and Mid-Term Quality of Life of an Innovative Robotic Approach. Healthcare 2024, 12, 1978. https://doi.org/10.3390/healthcare12191978
Cervigni M, Fuschi A, Morciano A, Campanella L, Carbone A, Schiavi MC. Obstructed Defecation Syndrome: Analysis of the Efficacy and Mid-Term Quality of Life of an Innovative Robotic Approach. Healthcare. 2024; 12(19):1978. https://doi.org/10.3390/healthcare12191978
Chicago/Turabian StyleCervigni, Mauro, Andrea Fuschi, Andrea Morciano, Lorenzo Campanella, Antonio Carbone, and Michele Carlo Schiavi. 2024. "Obstructed Defecation Syndrome: Analysis of the Efficacy and Mid-Term Quality of Life of an Innovative Robotic Approach" Healthcare 12, no. 19: 1978. https://doi.org/10.3390/healthcare12191978
APA StyleCervigni, M., Fuschi, A., Morciano, A., Campanella, L., Carbone, A., & Schiavi, M. C. (2024). Obstructed Defecation Syndrome: Analysis of the Efficacy and Mid-Term Quality of Life of an Innovative Robotic Approach. Healthcare, 12(19), 1978. https://doi.org/10.3390/healthcare12191978