Short-Term Lower Urinary Tract Symptom Trajectories After Hysterectomy With the Hugo™ RAS System: An Exploratory Secondary Analysis of a Prospective Cohort

Background Evidence for newer robotic platforms has focused primarily on perioperative feasibility. Patient-reported urinary recovery after Hugo™ robotic-assisted surgery (RAS) hysterectomy remains insufficiently characterized. Methods We performed an exploratory secondary analysis of prospectively collected outcomes from 45 consecutive Hugo RAS hysterectomies. Operative and learning-curve results from 43 overlapping cases were reported previously and were not reanalyzed. Verified outcomes were OABSS, ICIQ-SF, IPSS, and IPSS-QOL, assessed before surgery and at 1 and 3 months. Complete-case changes were evaluated with Friedman tests and Holm adjustment across four instruments. Eight paired Wilcoxon comparisons were exploratory and Holm-adjusted. Missing values were not imputed. Results The outcome worksheet contained 24 records; scorable baseline data were available for 23 patients, 1-month data for 16-18, and 3-month data for 12-13. Median OABSS was 2.0, 1.0, and 1.0 at baseline, 1 month, and 3 months. Corresponding medians were 0, 0, and 0 for ICIQ-SF; 3.0, 4.5, and 1.5 for IPSS; and 2.0, 2.0, and 1.0 for IPSS-QOL. No global test remained significant after Holm adjustment. The largest exploratory signal was a 1.5-point IPSS increase at 1 month (n = 16; unadjusted P = .013; adjusted P = .101). Conclusions Among respondents, urinary symptom burden was low, with no multiplicity-adjusted evidence of persistent change through 3 months. Attrition, absence of a comparator, and cohort overlap preclude platform-specific claims. Larger comparative studies require complete, auditable patient-reported outcomes.