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