Systematic review of the efficacy and safety of using mesh in surgery for uterine or vaginal vault prolapse.
OBJECTIVE
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.
Jia
Xueli
X
Health Services Research Unit, University of Aberdeen, Aberdeen AB25 2ZD, UK. x.jia@abdn.ac.uk
Glazener
Cathryn
C
Mowatt
Graham
G
Jenkinson
David
D
Fraser
Cynthia
C
Bain
Christine
C
Burr
Jennifer
J
D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods; D006801:Humans; D012449:Safety; D013526:Surgical Mesh / Q000009:adverse effects; D014596:Uterine Prolapse / Q000601:surgery*