Systematic review of the efficacy and safety of using mesh in surgery for uterine or vaginal vault prolapse

Abstract

Introduction and hypothesis: 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.