Association between anatomical correction and bladder emptying after robotic sacrocolpopexy: a retrospective cohort study

Abstract

The relationship between anatomical correction and bladder emptying after robotic sacrocolpopexy remains unclear. This study evaluated early postoperative changes in postvoid residual volume (PVR) and examined their association with changes in anterior compartment support. This single-center retrospective cohort study included consecutive patients who underwent robotic sacrocolpopexy for pelvic organ prolapse between April 2025 and April 2026. PVR was measured by transurethral catheterization on the day before surgery and on postoperative day 3. Anterior compartment support was assessed using pelvic organ prolapse quantification point Ba before surgery and approximately 1 month postoperatively. Changes were calculated as postoperative minus preoperative values (ΔPVR and ΔBa). The association between ΔBa and ΔPVR was evaluated using Spearman’s rank correlation, and an exploratory linear regression analysis adjusted for preoperative PVR was performed. Of 37 consecutive patients, 36 were included in the primary analysis. Median ΔBa was − 4.0 cm (interquartile range [IQR], − 5.0 to − 3.0; p < 0.001). Median PVR decreased from 28.0 mL (IQR, 15.0–96.3) preoperatively to 11.0 mL (IQR, 4.5–30.3) on postoperative day 3 ( p < 0.001), although individual changes varied widely. No statistically significant correlation was observed between ΔBa and ΔPVR (Spearman’s ρ = − 0.155; 95% confidence interval [CI], − 0.462 to 0.185; p = 0.367). In the baseline-adjusted regression analysis, ΔBa was not significantly associated with postoperative PVR (regression coefficient, − 1.345; 95% CI, − 13.270 to 10.580; p = 0.820). Robotic sacrocolpopexy was associated with improved anterior compartment support and an overall reduction in early postoperative PVR. However, the magnitude of anatomical correction was not significantly associated with the change in PVR. Given the small sample size and wide confidence interval, these findings should be considered exploratory. Anatomical and bladder emptying outcomes should therefore be assessed separately after robotic sacrocolpopexy.