title: Meta-analysis of the efficacy and safety of the application of adjuvant material in the repair of anterior vaginal wall prolapsed.
abstract: BACKGROUND
  This study is a meta-analysis of the efficacy and safety of the application of adjuvant material in the repair of anterior vaginal wall prolapse and a sub-category analysis of the use of nonabsorbable synthetic mesh, biological graft and absorbable synthetic mesh.
  
  
  METHODS
  Pubmed, Embase and Ovid databases were searched for published randomized controlled trials from 1980 to February 2012 on the treatment of anterior vaginal wall prolapse with adjuvant materials. A comprehensive meta-analysis applying Revman5.1 analysis software was performed.
  
  
  RESULTS
  A total of 20 randomized controlled trials including 2,313 participants were recognized. The result showed that repair with adjuvant materials was better and more effective; nevertheless, use of adjuvant materials resulted in longer duration of surgery and more peri-operative bleeding when compared with the control group, but no significant differences were observed between the two groups regarding visceral injury, postoperative pain, urinary tract infection rate, new stress incontinence and new dyspareunia.
  
  
  CONCLUSIONS
  Adjuvant material is worthy of clinical popularization, especially the biological graft type because of its lower anatomy failure rate and no difference in safety compared with the control group. However, exposure to adjuvant materials and erosion rate are high, which are the most important aspects to be improved.
authors.affiliation: Department of Gynecology and Obstetrics, Renmin Hospital of Wuhan University, Jiefang Road 238, Wuhan, Hubei, China.
authors.forename: Hu
authors.initials: H
authors.lastname: Min
authors.forename: Hong
authors.initials: H
authors.lastname: Li
authors.forename: Li
authors.initials: L
authors.lastname: Bingshu
authors.forename: Cheng
authors.initials: C
authors.lastname: Yanxiang
authors.forename: Chen
authors.initials: C
authors.lastname: Lu
authors.forename: Sun
authors.initials: S
authors.lastname: Qing
authors.forename: Zhu
authors.initials: Z
authors.lastname: Xuejiao
authors.forename: Wu
authors.initials: W
authors.lastname: Wenying
authors.forename: Wu
authors.initials: W
authors.lastname: Debin
authors.forename: Hong
authors.initials: H
authors.lastname: Shasha
authors.forename: Ding
authors.initials: D
authors.lastname: Wenjuan
authors.forename: Min
authors.initials: M
authors.lastname: Jie
authors.forename: Zhang
authors.initials: Z
authors.lastname: Xiaohong
authors.forename: Guo
authors.initials: G
authors.lastname: Wenjun
authors.forename: Chen
authors.initials: C
authors.lastname: Jianhua
authors.forename: Liu
authors.initials: L
authors.lastname: Qian
authors.forename: Liu
authors.initials: L
authors.lastname: Yuling
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical; D004414:Dyspareunia; D005260:Female; D006801:Humans; D008875:Middle Aged; D010149:Postoperative Pain / Q000453:epidemiology; D011183:Postoperative Complications; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence; D012086:Reoperation; D013526:Surgical Mesh; D013997:Time Factors; D019737:Transplants; D016896:Treatment Outcome; D014549:Urinary Incontinence; D014596:Uterine Prolapse / Q000601:surgery*