Highlights
- •Mesh repair was associated with a higher anatomical cure rate than native tissue repair when the follow-up was up to 24 months.
- •No differences were observed in the risk of re-operation between native tissue repair and mesh augmentation.
- •Pooled risk differences in the incidence of post-surgical and late complications were higher for the mesh repair intervention.
Abstract
The aim of the present systematic review and meta-analysis was to compare native tissue
repair (NTR) against transvaginal mesh augmentation for the repair of anterior vaginal
prolapse. A total of 2289 articles were found but only 27 (24.8 %) were included in
the review. Guidelines of the Preferred Reporting Items for Systematic Reviews and
Meta-Analysis (PRISMA) were followed to guide the process of the systematic review
and meta-analysis. The quality of the observational studies was evaluated according
to the Scottish Intercollegiate Guidelines Network, whereas the quality of randomized
control trials (RCT) was assessed by the Cochrane risk-of-bias scale. The mesh repair
intervention was associated with a higher anatomical cure rate in comparison with
NTR repair when the follow-up was ≤24 months [pooled risk difference (95 % CI): −0.18 %
(−0.22 %; 0.13 %); p-value: <0.0001; I2: 36.0 %]. Studies reporting anatomical failure had similar findings [pooled risk
difference (95 % CI): 0.17 % (0.01 %; 0.33 %); p-value: 0.03; I2: 88.6 %]. No differences in the risk of re-operation were observed between NTR repair
and mesh augmentation. Pooled risk differences in the incidence of post-surgical and
late complications were higher for the mesh repair intervention [−0.05 % (95 % CI:
−0.10 %; 0.00 %) p-value: 0.05; I2: 68.3 %] [−0.05 % (95 % CI: −0.14 %; 0.03 %) p-value: 0.25; I2: 82.0 %]. Women who underwent mesh repair reported greater satisfaction than women
who underwent NTR [pooled risk difference (95 % CI): −0.07 % (−0.16 %; 0.02 %); p-value:
0.15; I2: 65.3 %]. In conclusion, mesh repair surgery had higher anatomical cure and satisfaction
rates, with no differences in re-operation rate, but had higher post-surgical and
late complications in comparison with NTR.
Keywords
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Article info
Publication history
Published online: August 03, 2022
Accepted:
July 25,
2022
Received in revised form:
July 16,
2022
Received:
January 30,
2022
Identification
Copyright
© 2022 Elsevier B.V. All rights reserved.
