Systematic review of the efficacy and safety of using mesh in surgery for uterine or vaginal vault prolapse

Xueli Jia, Cathryn M A Glazener, Graham Mowatt, David Jenkinson, Cynthia Fraser, Christine Bain, Jennifer Burr

Research output: Contribution to journalArticle

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Abstract

Introduction and hypothesis
The aim of this study is to estimate efficacy and safety of mesh in surgery for uterine or vault prolapse.
Methods
Seventeen electronic databases were searched for relevant studies that were published from 1980 onwards.
Results
Fifty-four studies involving 7,054 women were included. For sacrocolpopexy (average follow-up 23 months), the risk of clinical recurrence ranged from 0% to 6%, persistent symptoms ranged from 3% to 31% and mesh erosion from 0% to 12%. For infracoccygeal sacropexy (average follow-up 13 months), the risk of clinical recurrence ranged from 0% to 25%, persistent symptoms from 2% to 21% and mesh erosion 0% to 21%. Limited evidence was available for sacrocolpoperineopexy and uterine suspension sling to draw reliable estimates.
Conclusions
Sacrocolpopexy was associated with a low risk of recurrence but with a relatively high risk of mesh erosion. Ranges of estimates for outcomes for other mesh techniques were wide.
Original languageEnglish
Pages (from-to)1413-1431
Number of pages19
JournalInternational Urogynecology Journal
Volume21
Issue number11
Early online date15 Jun 2010
DOIs
Publication statusPublished - 1 Nov 2010

Fingerprint

Pelvic Organ Prolapse
Safety
Recurrence
Prolapse
Suspensions
Databases

Keywords

  • efficacy
  • mesh
  • mesh erosion
  • NICE
  • pelvic organ prolapsed
  • safety
  • systematic review

Cite this

Systematic review of the efficacy and safety of using mesh in surgery for uterine or vaginal vault prolapse. / Jia, Xueli; Glazener, Cathryn M A; Mowatt, Graham; Jenkinson, David; Fraser, Cynthia; Bain, Christine; Burr, Jennifer.

In: International Urogynecology Journal, Vol. 21, No. 11, 01.11.2010, p. 1413-1431.

Research output: Contribution to journalArticle

Jia, Xueli ; Glazener, Cathryn M A ; Mowatt, Graham ; Jenkinson, David ; Fraser, Cynthia ; Bain, Christine ; Burr, Jennifer. / Systematic review of the efficacy and safety of using mesh in surgery for uterine or vaginal vault prolapse. In: International Urogynecology Journal. 2010 ; Vol. 21, No. 11. pp. 1413-1431.
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AU - Fraser, Cynthia

AU - Bain, Christine

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AB - Introduction and hypothesisThe aim of this study is to estimate efficacy and safety of mesh in surgery for uterine or vault prolapse.MethodsSeventeen electronic databases were searched for relevant studies that were published from 1980 onwards.ResultsFifty-four studies involving 7,054 women were included. For sacrocolpopexy (average follow-up 23 months), the risk of clinical recurrence ranged from 0% to 6%, persistent symptoms ranged from 3% to 31% and mesh erosion from 0% to 12%. For infracoccygeal sacropexy (average follow-up 13 months), the risk of clinical recurrence ranged from 0% to 25%, persistent symptoms from 2% to 21% and mesh erosion 0% to 21%. Limited evidence was available for sacrocolpoperineopexy and uterine suspension sling to draw reliable estimates.ConclusionsSacrocolpopexy was associated with a low risk of recurrence but with a relatively high risk of mesh erosion. Ranges of estimates for outcomes for other mesh techniques were wide.

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