ArticleInternational urogynecology journal2026
Quality-Adjusted Life-Years Outcome 1 Year After Surgery by Robotics-Assisted Sacral Hystero-Colpopexy Versus Vaginal Mesh for Pelvic Organ Prolapse Repair.
Article in International urogynecology journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introduction and hypothesisThe aim of this study was to compare the quality-adjusted life-years (QALYs) attained 1 year after robotics-assisted sacral hystero-colpopexy (RASC) versus Uphold™ vaginal mesh surgery for pelvic organ prolapse repair.
methodsThis was a secondary analysis of a previously published cohort study. A total of 65 patients who underwent RASC and 71 who underwent the Uphold™ procedure completed the 15-dimensional (15D) and the EuroQol five-dimensional three-level (EQ-5D-3L) instruments measuring health-related quality of life (HR-QoL). All patients had symptomatic and anatomical apical prolapse (POP-Q C ≥ stage II) with or without other vaginal wall defects. Changes in HR-QoL instruments were calculated and compared with minimal important change (MIC) thresholds and QALYs gained were estimated for each intervention.
resultsThe 15D and EQ-5D-3L mean index scores were improved from preoperatively to 1 year after RASC ([0.88 ± 0.10 to 0.90 ± 0.01] and [0.85 ± 0.1 to 0.90 ± 0.1]) and after Uphold™= ([0.87 ± 0.1 to 0.89 ± 0.1] and [0.86 ± 0.1 to 0.93 ± 0.1], p 0.024 to p < 0.001) with no significant difference between cohorts. Prolapse-related 15D profile index measures, including discomfort, sexual activity, and distress were significantly improved after RASC (p = 0.039 to < 0.001), whereas excretion, discomfort, and sexual activity were significantly improved after the Uphold™ (p = 0.009 to < 0.001). The improvement in 15D scores from baseline to 1-year follow-up of + 0.026 for RASC and + 0.025 for Uphold™ exceeded the MIC, indicating meaningful improvements in patient quality of life. The overall 1-year QALY gain was estimated to be 0.90 ± 0.1 in the RASC and 0.88 ± 0.1 in the Uphold™ cohorts (p < 0.001), with no significant difference between the two interventions (p = 0.514).
conclusionsThe RASC and Uphold™ are both meaningful surgical treatments for prolapse, with significant improvement in the HR-QoL and the 1-year QALY gain and with no significant difference between the two surgeries.
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