CoChat
Sign Up
Cited by 784Pelvic floor disorders treatmentsUterine Myomas and TreatmentsHernia repair and management

The DOI matches its Crossref record; 109 of the 109 references it cites were found in a registry or an index.

Surgical management of pelvic organ prolapse in women

Maher, Christopher, Feiner, Benjamin, Baessler, Kaven, Schmid, Corina·2013·Cochrane Database of Systematic Reviews
DOI 10.1002/14651858.cd004014.pub5
Open this paper in CoChat — free account

Abstract

Pelvic organ prolapse may occur in up to 50% of parous women. A variety of urinary, bowel and sexual symptoms may be associated with the prolapse.To determine the effects of the many different surgeries used in the management of pelvic organ prolapse.We searched the Cochrane Incontinence Group Specialised Register, which contains trials identified from the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, MEDLINE In Process and handsearching of journals and conference proceedings, healthcare-related bibliographic databases, handsearched conference proceedings (searched 20 August 2012), and reference lists of relevant articles. We also contacted researchers in the field.Randomised or quasi-randomised controlled trials that included surgical operations for pelvic organ prolapse.Trials were assessed and data extracted independently by two review authors. Six investigators were contacted for additional information with five responding.Fifty-six randomised controlled trials were identified evaluating 5954 women. For upper vaginal prolapse (uterine or vault) abdominal sacral colpopexy was associated with a lower rate of recurrent vault prolapse on examination and painful intercourse than with vaginal sacrospinous colpopexy. These benefits must be balanced against a longer operating time, longer time to return to activities of daily living and increased cost of the abdominal approach. In single studies the sacral colpopexy had a higher success rate on examination and lower reoperation rate than high vaginal uterosacral suspension and transvaginal polypropylene mesh.Twenty-one trials compared a variety of surgical procedures for anterior compartment prolapse (cystocele). Ten compared native tissue repair with graft (absorbable and permanent mesh, biological grafts) repair for anterior compartment prolapse. Native tissue anterior repair was associated with more recurrent anterior compartment prolapse than when supplemented with a polyglactin (absorbable) mesh inlay (RR 1.39, 95% CI 1.02 to 1.90) or porcine dermis mesh inlay (RR 2.08, 95% CI 1.08 to 4.01), however there was no difference in post-operative awareness of prolapse after absorbable mesh (RR 0.96, 95% CI 0.33 to 2.81) or a biological graft (RR 1.21, 95% CI 0.64 to 2.30). Data on morbidity and other clinical outcomes were lacking. Standard anterior repair was associated with more anterior compartment prolapse on examination than for any polypropylene (permanent) mesh repair (RR 3.15, 95% CI 2.50 to 3.96). Awareness of prolapse was also higher after the anterior repair as compared to polypropylene mesh repair (28% versus 18%, RR 1.57, 95% CI 1.18 to 2.07). However, the reoperation rate for prolapse was similar at 14/459 (3%) after the native tissue repair compared to 6/470 (1.3%) (RR 2.18, 95% CI 0.93 to 5.10) after the anterior polypropylene mesh repair and no differences in quality of life data or de novo dyspareunia were identified. Blood loss (MD 64 ml, 95% CI 48 to 81), operating time (MD 19 min, 95% CI 16 to 21), recurrences in apical or posterior compartment (RR 1.9, 95% CI 1.0 to 3.4) and de novo stress urinary incontinence (RR 1.8, 95% CI 1.0 to 3.1) were significantly higher with transobturator meshes than for native tissue anterior repair. Mesh erosions were reported in 11.4% (64/563), with surgical interventions being performed in 6.8% (32/470).Data from three trials compared native tissue repairs with a variety of total, anterior, or posterior polypropylene kit meshes for vaginal prolapse in multiple compartments. While no difference in awareness of prolapse was able to be identified between the groups (RR 1.3, 95% CI 0.6 to 1.7) the recurrence rate on examination was higher in the native tissue repair group compared to the transvaginal polypropylene mesh group (RR 2.0, 95% CI 1.3 to 3.1). The mesh erosion rate was 35/194 (18%), and 18/194 (9%) underwent surgical correction for mesh erosion. The reoperation rate after transvaginal polypropylene mesh repair of 22/194 (11%) was higher than after the native tissue repair (7/189, 3.7%) (RR 3.1, 95% CI 1.3 to 7.3).Data from three trials compared posterior vaginal repair and transanal repair for the treatment of posterior compartment prolapse (rectocele). The posterior vaginal repair had fewer recurrent prolapse symptoms (RR 0.4, 95% CI 0.2 to 1.0) and lower recurrence on examination (RR 0.2, 95% CI 0.1 to 0.6) and on defecography (MD -1.2 cm, 95% CI -2.0 to -0.3).Sixteen trials included significant data on bladder outcomes following a variety of prolapse surgeries. Women undergoing prolapse surgery may have benefited from having continence surgery performed concomitantly, especially if they had stress urinary incontinence (RR 7.4, 95% CI 4.0 to 14) or if they were continent and had occult stress urinary incontinence demonstrated pre-operatively (RR 3.5, 95% CI 1.9 to 6.6). Following prolapse surgery, 12% of women developed de novo symptoms of bladder overactivity and 9% de novo voidi

Overview

Integrity signals

Registry

Crossref · 10.1002/14651858.cd004014.pub5

Cites

109 of 109 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Verification

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Citations

Cites

Show all 109 references

Research works printed but not linked: 46

  1. Ali, 2006, A prospective randomized trial using Gynemesh PS (trademark) for the repair of anterior vaginal wall prolapse (Abstract number 292), International Urogynecology Journal and Pelvic Floor Dysfunction, 17 Suppl 2, 221
  2. Al-Nazer, 2007, Comparative study between anterior colporraphy versus vaginal wall repair with mesh for management of anterior vaginal wall prolapse (Abstract number 84), International Urogynecology Journal and Pelvic Floor Dysfunction, 18 Suppl 1, 49
  3. Borstad, 2008, Surgery for concomitant pelvic organ prolapse and urinary stress incontinence. A multicenter prospective randomized trial to compare the results of an incontinence procedure performed at the time of prolapse repair or 3 months after (Abstract number 120), Neurourology and Urodynamics, 27, 713
  4. Borstad, 2006, An incontinence procedure performed at the time of prolapse repair might be unnecessary surgery (Abstract number 35), Neurourology and Urodynamics, 25, 551
  5. Braun, 2007, Prospective randomised study to compare colposacropexy and Mayo McCall technique in the correction of severe genital central prolapse (Abstract number 19), International Urogynecology Journal, 18 Suppl 1, 12
  6. Costantini, 2007, Must colposuspension be associated with sacropexy to prevent postoperative urinary incontinence?, European Urology, 51, 788, 10.1016/j.eururo.2006.08.034 · DOI
  7. Ridder, 2004, Procine dermis xenograft as reinforcement for cystocele stage III repair: a prospective randomized controlled trial (Abstract), Neurourology and Urodynamics, 23, 435
  8. Dietz, 2008, Sacrospinous hysteropexy and vaginal hysterectomy for uterine descent: A randomized study (Abstract number 92), International Urogynecology Journal, 19 Suppl 1, S94
  9. Feldner, 2009, Surgical treatment of anterior vaginal wall prolapse: comparison of small intestine submucosa (SIS) graft and traditional repair (Abstract number 160), International Urogynecology Journal, 20 Suppl 2, S208
  10. Gandhi, 2004, A randomized controlled trial of fascia lata for the prevention of recurrent anterior vaginal wall prolapse, Neurourology and Urodynamics, 23, 558
  11. Guerette, 2006, Multi-center, randomized, prospective trial comparing anterior colporrhaphy alone to bovine pericardium collagen matrix graft reinforced anterior colporrhaphy: 12-month analysis (Abstract number 11), International Urogynecology Journal and Pelvic Floor Dysfunction, 17 Suppl 2, 63
  12. Halaska, 2012, A multicentre randomized prospective controlled study comparing sacrospinous fixation and transvaginal mesh in the treatment of posthysterectomy vaginal vault prolpase, American Journal of Obstetrics and Gynecology, 207, e1
  13. Kahn, 1998, Posterior colporrhaphy vs transanal repair of the rectocele: an initial follow up of a prospective randomized controlled trial, British Journal of Obstetrics and Gynaecology, 105 Suppl 17, 57
  14. Kahn, 1999, Posterior colporrhaphy is superior to the transanal repair for treatment of posterior vaginal wall prolapse, Neurourology and Urodynamics, 18, 329
  15. Maher, 2009, Laparoscopic sacral colpopexy versus total vaginal mesh for the management of vaginal vault prolapse: a randomized controlled trial (Abstract number 089), International Urogynecology Journal, 20 Suppl 2, S151
  16. Dyer, 2009, The Optimal Anterior Repair Study (OARS): a triple arm randomized double blinded clinical trial of standard colporrhaphy, porcine dermis or polypropylene mesh augmented anterior vaginal wall repair (Abstract number 252), Neurourology and Urodynamics, 28, 894
  17. Dyer, 2010, The Optimal Anterior Repair Study (OARS): a triple arm randomized double blinded clinical trial of standard colporraphy versus vaginal paravaginal repair with porcine dermis graft or polypropylene mesh (Abstract number 281), Neurourology and Urodynamics, 29, 1207
  18. Meschia, 2001, A randomized prospective comparison of TVT and endopelvic fascia plication in the treatment of occult stress urinary incontinence in patients with severe genital prolapse (Abstract), International Urogynecology Journal and Pelvic Floor Dysfunction, 12 Suppl 3, 10
  19. Meschia, 2005, Porcine skin collagen implants (Pelvicol) (trademark) to prevent anterior vaginal wall prolapse recurrence: a randomized study (Abstract), Neurourology and Urodynamics, 24, 587
  20. Minassian, 2010, Randomized controlled trial comparing anterior colporrhaphy to abdominal paravaginal defect repair for anterior vaginal wall prolapse (Abstract number 54), Neurourology and Urodynamics, 29, 885
  21. Cervigni, 2005, Prospective randomized trial of two new materials for the correction of anterior compartment prolapse: Pelvicol and Prolene Soft (Abstract), Neurourology and Urodynamics, 24, 585
  22. Pantazis, 2011, Open and laparoscopic sacrocolpopexy demonstrate clinical equivalence: one year results from the LAS Trial, an RCT comparing the two approaches for treating post hysterectomy vault prolapse (Abstract number 131), Neurourology and Urodynamics, 30, 986
  23. Pantazis, 2008, Results from the LAS trial, an RCT comparing open abdominal to laparoscopic sacrocolpopexy for the treatment of post hysterectomy vault prolapse (Abstract number 120), International Urogynecology Journal, 19 Suppl 1, 101
  24. Paraiso, 2010, Conventional laparoscopic versus robotic-assisted laparoscopic sacral colpopexy: a randomized controlled trial (Abstract number 108), Neurourology and Urodynamics, 29, 964
  25. Rondini, 2010, Prospective-randomized study comparing high uterosacral vault suspension vs. abdominal sacrocolpopexy for the repair of apical defects and vaginal vault prolapse (Abstract number 90), Neurourology and Urodynamics, 29, 939
  26. Rondini, 2011, Prospective-randomised study comparing high uterosacral vault suspension vs abdominal sacral colpopexy for the correction of apical defects and vaginal vault prolapse (Abstract number: presentation 88), International Urogynecology Journal and Pelvic Floor Dysfunction, 22 Suppl 1, S87
  27. Roovers, 2008, Long term follow-up of a randomized controlled trial comparing abdominal and vaginal surgical correction of uterine prolapse (Abstract number 88), International Urogynecology Journal, 19 Suppl 1, 91
  28. Roovers, 2001, A randomized controlled trial comparing abdominal and vaginal prolapse surgery of patients with descensus uteri grade II - IV (Abstract), International Urogynaecology Journal, 12 Suppl 3, S109
  29. Schierlitz, 2007, A prospective randomised controlled study comparing vaginal prolapse repair with and without tension free vaginal tape (TVT) in women with severe pelvic organ prolapse and occult stress incontinence (Abstract number 114), Neurourology and Urodynamics, 26, 743
  30. Thijs, 2010, A randomized controlled trial of anterior colporraphy and Perigee™ as a primary surgical correction of symptomatic cystocele (Abstract number 96), International Urogynecology Journal and Pelvic Floor Dysfunction, 21 Suppl 1, S142
  31. Vijaya, 2011, A prospective randomised trial comparing two surgical techniques for posterior vaginal wall prolapse using subjective and objective measures (Abstract number 52), Neurourology and Urodynamics, 30, 872
  32. Vollebregt, 2010, One year results of colporraphy anterior versus a trocar guided transobturator synthetic mesh in primary cystocele repair: a randomized controlled trial (Abstract number 51), Neurourology and Urodynamics, 29, 880
  33. Kenton, 2011, The value of the preoperative prolapse reduction stress test in women without stress incontinence symptoms undergoing vaginal prolapse surgery with or without a TVT: result from the OPUS trial (Abstract 50), Neurourology and Urodynamics, 30, 870
  34. Wei, 2011, A mid urethral sling prevents incontinence among women undergoing vaginal prolapse repair - the OPUS trial (Abstract number 5), Neurourology and Urodynamics, 30, 809
  35. Withagen, 2009, Tension free vaginal mesh compared to conventional vaginal prolapse surgery in recurrent prolapse; a randomized controlled trial (Abstract number 090), International Urogynaecology Journal, 20 Suppl 2, S153
  36. Carramao, 2009, A randomized comparison of two vaginal procedures for the treatment ofuterine prolapse using polypropylene mesh: histeropexy versus histerectomy, Revista do Colegio Brasileiro de Cirurgioes, 36, 65
  37. Carramao, 2008, A randomized comparison of two vaginal surgery for pelvic organ prolapse: Histerectomy with vaginal sacrospinous ligament fixation versus histeropexy with repair of pelvic floor using mesh (Abstract number 93), International Urogynecology Journal, 19 Suppl 1, 96
  38. Guvenal, 2002, The role of prophylactic sacrospinous ligament fixation and sacrocolpopexy after hysterectomy in patients with uterovaginal relaxation: A controlled clinical trial. [Turkish], Jinekoloji Ve Obstetrik Dergisi, 16, 213
  39. Juneja, 2010, Hysterectomy vs no hysterectomy for uterine prolapse in conjunction with posterior infracococcygeal colpopexy - a randomised pilot study 12 months review (Abstract number 692)
  40. Kwon, 2002, Protective effect of transvaginal slings on recurrent anterior vaginal wall prolapse after pelvic reconstructive surgery, Neurourology and Urodynamics, 21, 321
  41. Meschia, 2007, A multicenter randomized trial on transvaginal mesh repair of severe genital prolapse with the perigee-apogee system. The Perapo study (Abstract number 16), International Urogynecology Journal and Pelvic Floor Dysfunction, 18 Suppl 1, 10
  42. Mouritsen, 2009, Results after vaginal repair of recurrent prolapse with and without xenograft reinforcement - a randomized study (Abstract number 112), International Urogynecology Journal and Pelvic Floor Dysfunction, 20 Suppl 2, S173
  43. Quadri, 1985, Randomized surgery for incontinence and prolapse: Retropubic colposuspension vs anterior repair (abstract), Archives of Gynecology, 237 Suppl, 402
  44. Brubaker, 2002, Pelvic organ prolapse, 243
  45. Ek, 2010, Urodynamic assessment of anterior v aginal w all s urgery: A r andomized comparison between colporraphy and transvaginal mesh, Neurourology and Urodynamics, 29, 527, 10.1002/nau.20811 · DOI
  46. Visco, 2008, The role of preoperative urodynamic testing in stress-continent women undergoing sacrocolpopexy: the Colpopexy and Urinary Reduction Efforts (CARE) randomized surgical trial, International Urogynecology Journal., 19, 607, 10.1007/s00192-007-0498-2 · DOI

Cited by

Sorted by citations

Related

See all

Metadata

Authors
Maher, C., Feiner, B., Baessler, K., & Schmid, C.
Affiliations
  • Royal Brisbane and Women's Hospital (AU)
  • Hillel Yaffe Medical Center (IL)
  • Charité – Universitätsmedizin Berlin (DE)
ORCID
Venue
Cochrane Database of Systematic Reviews
Publisher
John Wiley & Sons, Ltd
Published
2013-04-30
ISSN
1361-6137 (ISSN-L)
DOI
10.1002/14651858.cd004014.pub5
OpenAlex
W3041820159
Cited by
784
References
109
Citations by year
2026: 22 · 2025: 58 · 2024: 43 · 2023: 45 · 2022: 67 · 2021: 48 · 2020: 52 · 2019: 53 · 2018: 63 · 2017: 86 · 2016: 101 · 2015: 76 · 2014: 52 · 2013: 12
Type
reference entry
Language
en
Update notices
new_version (2016-11-30)
Open access
closed
Locations
Cochrane Database of Systematic Reviews (publishedVersion)
Topics
  • Health Sciences › Medicine › Urology › Pelvic floor disorders treatments
  • Health Sciences › Medicine › Obstetrics and Gynecology › Uterine Myomas and Treatments
  • Health Sciences › Medicine › Surgery › Hernia repair and management
Keywords
pelvic organ prolapse, pelvic floor surgery, sacrocolpopexy, transvaginal mesh repair, cystocele repair, polypropylene mesh, native tissue repair, postoperative complications, sexual dysfunction, urinary incontinence, bowel dysfunction

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review