Introduction: We present the preliminary report of the first 60 cases of robotic sacrocolpopexy (RSCP) performed with a minimally invasive approach by using the new HUGO RAS system (Medtronic) with the aim of assessing its feasibility, safety and efficacy.Methods: Results in terms of operative time, intraoperative blood loss, post-operative pain, length of hospitalisation, intra and post-operative complications were comparable to previously described laparoscopic and robotic techniques.Results: Urogynecological assessment at three months follow up showed surgical anatomic success in 96.7% of patients (<2 POP-Q stage), while subjective cure rate was 98.3%.Conclusions: This is the first series analyzing RSCP outcomes for POP using the new Hugo RAS system. Our results suggest effectiveness both in objective and subjective outcomes, with minimal intra and post-operative complications. Larger series as well as longer follow-up are needed to better define advantages and possible disadvantages of this novel system. Our work may represent the basis of future studies to confirm its safety, efficacy and feasibility, and may provide technical notes for other centres that wish to perform RSCP through this innovative system.

Background/Objectives: The role of urodynamic study (UDS) in women with pelvic organ prolapse (POP) and concurrent lower urinary tract symptoms (LUTS) remains controversial. Although LUTS alone often fail to yield an accurate diagnosis, routine UDS is debated due to its invasiveness, cost, patient discomfort, and risk of urinary tract infections. The aim of this narrative review is to summarise the utility of UDS in the pre- and postoperative management of POP, focusing on its role in diagnosing and predicting outcomes for detrusor overactivity (DO), bladder outlet obstruction (BOO), detrusor underactivity (DU), and SUI. Methods: An extensive search of the available medical literature was conducted using PubMed, Scopus, and Embase to identify relevant studies published up to December 2024. The search combined keywords and MeSH terms related to pelvic organ prolapse (POP), urodynamic studies (UDS), overactive bladder, detrusor overactivity, stress urinary incontinence (SUI), female bladder outlet obstruction (BOO), detrusor underactivity (DU), preoperative assessment, and postoperative outcomes. Results: Occult stress urinary incontinence (SUI) detection with UDS can aid in planning concurrent anti-incontinence procedures, while preoperative assessment of DO or DU helps predict postoperative complications like urinary retention or overactive bladder symptoms. Conclusions: Despite its diagnostic advantages, evidence on UDS parameters and surgical outcomes remains inconsistent. The most important societies’ guidelines promote the use of UDS in selected cases, highlighting the need for individualised assessments to optimise patient counselling and management strategies.

Background: Pelvic organ prolapse (POP) frequently coexists with overactive bladder (OAB) symptoms, yet the impact of surgical correction on OAB outcomes remains incompletely characterized across different surgical approaches. Objectives: To quantify OAB symptom resolution rates following POP surgery, compare outcomes across surgical techniques, evaluate de novo OAB incidence, and identify predictive factors for postoperative OAB persistence or development. Search Strategy: Comprehensive search of MEDLINE, Embase, Web of Science, Scopus, Cochrane CENTRAL, ClinicalTrials.gov , and LILACS through December 31, 2024, limited to English language articles. Selection Criteria: Comparative studies (randomized controlled trials and observational studies) including adult women with symptomatic POP (POP‐Q stage ≥II) undergoing surgical correction, reporting validated OAB outcomes with minimum 3‐month follow‐up. Data Collection and Analysis: Three independent reviewers extracted data using predefined criteria. Random‐effects meta‐analyses with Freeman‐Tukey double arcsine transformation were performed. Quality assessment employed Cochrane Risk of Bias 2.0, Newcastle‐Ottawa Scale, and GRADE methodology. Main Results: Twenty‐four studies encompassing 7739 women (7095 analyzed) were included. Overall OAB resolution rate was 58.0% (95% CI: 55.9%–60.1%; I ² = 83.9%). No significant differences emerged between vaginal, laparoscopic/robotic, or abdominal approaches ( p = 0.62), or between mesh‐augmented versus native tissue repairs ( p = 0.48). Compartment‐specific analysis revealed anterior/apical repairs achieved significantly higher resolution (75.8%, 95% CI: 73.2%–78.3%) compared to isolated posterior repairs (28.3%, 95% CI: 20.1%–37.9%; p < 0.001). De novo OAB incidence ranged 0%–14.3%, though reporting was limited to 6 studies. Conclusions: POP surgery resolves preexisting OAB in approximately three‐fifths of patients, with anatomical compartment representing the strongest predictor. Anterior/apical prolapse correction offers superior OAB outcomes compared to posterior repair, independent of surgical approach or mesh utilization.