Cited by 26Pelvic floor disorders treatmentsHernia repair and managementUterine Myomas and Treatments

Sacrocolpopexy compared with transvaginal mesh surgery: A systematic review and meta-analysis

Zhang, C‐Y, Sun, Z‐J, Yang, J, Xu, T, Zhu, L, Lang, J‐H·2021·BJOG: An International Journal of Obstetrics & Gynaecology

Abstract

Background: The use of mesh is controversial in the treatment of female pelvic organ prolapse. Objectives: To systematically review the outcomes of sacrocolpopexy compared with transvaginal mesh surgery and to provide evidence‐based suggestions. Search strategy: The MEDLINE, EMBASE, Cochrane Library and clinicaltrials.gov databases were searched on 21 November 2018. Selection criteria: Randomised controlled trials and prospective and retrospective cohort studies were included. Data collection and analysis: Data were extracted by one reviewer and examined by a second reviewer for accuracy. Odds ratios and 95% CI were calculated using random‐effects models. Main results: Twenty comparative studies were included. The meta‐analysis was performed with subgroups. The summary odds ratios of the randomised controlled group were 1.84 (95% CI 0.79–4.29, I2 = 75%) for anatomical success, 1.41 (95% CI 0.47–4.24, I2 = 38%) for subjective success, 0.42 (95% CI 0.18–0.98, I2 = 0%) for mesh complications, 0.61 (95% CI 0.20–1.91, I2 = 0%) for prolapse reoperation and 0.44 (95% CI 0.23–0.88, I2 = 0%) for de novo dyspareunia. The mean differences were 0.77 (95% CI 0.31–1.23, I2 = 66%) for total vaginal length and −1.28 (95% CI −2.00 to −0.55, I2 = 66%) for point C after surgery. Conclusions: Very‐low‐quality evidence indicated that the anatomical and subjective success rates of sacrocolpopexy were similar to those of transvaginal mesh surgery; sacrocolpopexy might be more beneficial than transvaginal mesh surgery in terms of mesh‐related complication rates, prolapse recurrence and de novo dyspareunia. However, additional high‐quality randomised trials with long‐term follow‐up durations are needed. Tweetable abstract: Sacrocolpopexy is beneficial after surgical anatomical changes and has decreased rates of mesh‐related complications and dyspareunia.

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Crossref · 10.1111/1471-0528.16324

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Authors
Zhang, C., Sun, Z., Yang, J., Xu, T., Zhu, L., & Lang, J.
Affiliations
Chinese Academy of Medical Sciences & Peking Union Medical College (CN)
Corresponding author
  • Sun, Z‐J
  • Zhu, L
Venue
BJOG: An International Journal of Obstetrics & Gynaecology
Publisher
Wiley
Published
2020-06-15
Volume
128
Issue
1
Pages
14-23
ISSN
  • 0306-5456 (ISSN-L)
  • 1470-0328
  • 1471-0528
OpenAlex
W3026615791
Cited by
26
References
49
Citations by year
2026: 5 · 2025: 4 · 2024: 7 · 2023: 7 · 2022: 2 · 2021: 1
FWCI
0.39
Type
journal article
Language
en
Open access
closed
Locations
  • BJOG An International Journal of Obstetrics & Gynaecology (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Natural Science Foundation of China (81671442, 81971366)
Topics
  • Health Sciences › Medicine › Rheumatology › Pelvic floor disorders treatments
  • Health Sciences › Medicine › Surgery › Hernia repair and management
  • Health Sciences › Medicine › Obstetrics and Gynecology › Uterine Myomas and Treatments
Keywords
sacrocolpopexy, transvaginal mesh surgery, female pelvic organ prolapse, mesh complications, prolapse recurrence, anatomical success, subjective success, vaginal length, surgical outcomes comparison, long-term follow-up, quality of evidence, subgroup analysis
MeSH terms
Female, Humans, Gynecologic Surgical Procedures, Surgical Mesh, Suture Techniques, Urinary Incontinence, Stress, Randomized Controlled Trials as Topic, Pelvic Organ Prolapse

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