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Cost-effectiveness and patient-reported outcomes of combined versus isolated robotic rectal and pelvic organ prolapse repair: A multicentre prospective cohort study.

Cost-effectiveness and patient-reported outcomes of combined versus isolated robotic rectal and pelvic organ prolapse repair: A multicentre prospective cohort study. Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland Wallace, S. L., Ogilvie, J. W., Bordeianou, L., Earley, M., Platte, R., Weinstein, M. M., Sokol, E. R., Enemchukwu, E. A., Mishra, K., Gurland, B. H. 2026; 28 (8): e70570

Abstract

Rectal prolapse (RP) and pelvic organ prolapse (POP) frequently coexist, yet are often evaluated and treated separately. This study aimed to compare patient-reported outcomes and cost-effectiveness of combined versus isolated robotic prolapse repair.We conducted a prospective multicentre cohort study across three tertiary pelvic floor centres. Women undergoing robotic rectal prolapse repair (rRP), robotic pelvic organ prolapse repair (rPOP) or combined robotic repair (rRP + rPOP) were included. Validated patient-reported outcome measures were collected at baseline and 12 months. Health utility was derived from EQ-5D-3L and used to calculate quality-adjusted life years (QALYs). A trial-based cost-effectiveness analysis was performed from the healthcare sector perspective. A theoretical cohort was modelled to examine staged versus combined repair in patients with multicompartment prolapse.Forty-seven patients were included (rRP n = 14, rPOP n = 16, rRP + rPOP n = 17). All groups demonstrated significant improvement in pelvic floor symptoms and quality of life at 12 months. Improvements across bowel, bladder and prolapse-related domains were greatest in the combined repair group. Health utility gains were observed in all cohorts. In patients with multicompartment prolapse, combined robotic repair was cost-effective, whereas staged procedures were associated with higher cumulative costs without proportional gains in QALYs.Within robotic prolapse surgery, combined rectal and pelvic organ prolapse repair provides the most comprehensive symptom improvement and represents a cost-effective strategy when both compartments are symptomatic. These findings support systematic evaluation for multicompartment prolapse and multidisciplinary surgical planning.

View details for DOI 10.1111/codi.70570

View details for PubMedID 42543563

View details for PubMedCentralID PMC13429890