Mesh Exposure and Long-Term Outcomes in Robotic Sacrocolpopexy with Concomitant Radical Hysterectomy.

OBJECTIVES: To evaluate prolapse recurrence, mesh exposure, and de novo incontinence following robotic sacrocolpopexy (rSCP) with radical hysterectomy (rRH) for cancer and non-cancer indications. METHODS: We conducted a retrospective cohort study of patients undergoing concurrent rSCP and rRH at a tertiary referral center, July 2006-August 2023. Outcomes included prolapse recurrence (≥ stage 2 by POP-Q or symptomatic recurrence), mesh exposure, and de novo urinary incontinence within 12 months. Kaplan-Meier analyses estimated time to prolapse recurrence and mesh exposure stratified by indication (cancer vs non-cancer). RESULTS: In total, 109 patients underwent rSCP with rRH (36 for cancer, 73 for non-cancer indications). Median follow-up among patients without recurrence or mesh exposure was 15 months (IQR 7.5-43). Prolapse recurrence occurred in 12 patients: 1/36 and 11/73 in the cancer and non-cancer cohorts, respectively. One patient in each group required postoperative revision surgery after ≥10 years). Mesh exposure occurred in 8 patients: 1/36 and 7/73 in the cancer and non-cancer cohorts, respectively; 5 patients underwent surgical revision. Among 54 patients with ≥12 months follow-up and available continence data, de novo incontinence developed in 4 (7.4%) patients (3 cancer, 1 non-cancer). CONCLUSIONS: Concomitant rSCP-rRH demonstrates acceptable rates of prolapse recurrence, mesh exposure, and de novo incontinence. Although underpowered to detect small differences, outcomes were comparable in cancer vs non-cancer cases. rSCP can safely be integrated in rRH when clinically indicated.