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. 2024 Mar 13;3(3):CD012079.
doi: 10.1002/14651858.CD012079.pub2.

Transvaginal mesh or grafts or native tissue repair for vaginal prolapse

Ellen Yeung  1   2 , Kaven Baessler  3 , Corina Christmann-Schmid  4 , Nir Haya  5 , Zhuoran Chen  6 , Sheila A Wallace  7 , Alex Mowat  8 , Christopher Maher  9
Affiliations

Transvaginal mesh or grafts or native tissue repair for vaginal prolapse

Ellen Yeung et al. Cochrane Database Syst Rev. .

Abstract

Background: Pelvic organ prolapse is the descent of one or more of the pelvic organs (uterus, vaginal apex, bladder, or bowel) into the vagina. In recent years, surgeons have increasingly used grafts in transvaginal repairs. Graft material can be synthetic or biological. The aim is to reduce prolapse recurrence and surpass the effectiveness of traditional native tissue repair (colporrhaphy) for vaginal prolapse. This is a review update; the previous version was published in 2016.

Objectives: To determine the safety and effectiveness of transvaginal mesh or biological grafts compared to native tissue repair or other grafts in the surgical treatment of vaginal prolapse.

Search methods: We searched the Cochrane Incontinence Group Specialised Register, which contains trials identified from the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, and two clinical trials registers (March 2022).

Selection criteria: Randomised controlled trials (RCTs) comparing different types of vaginal repair (mesh, biological graft, or native tissue).

Data collection and analysis: Two review authors independently selected trials, assessed risk of bias, and extracted data. The primary outcomes were awareness of prolapse, repeat surgery, and recurrent prolapse on examination.

Main results: We included 51 RCTs (7846 women). The certainty of the evidence was largely moderate (ranging from very low to moderate). Transvaginal permanent mesh versus native tissue repair Awareness of prolapse at six months to seven years was less likely after mesh repair (risk ratio (RR) 0.83, 95% confidence interval (CI) 0.73 to 0.95; I2 = 34%; 17 studies, 2932 women; moderate-certainty evidence). This suggests that if 23% of women are aware of prolapse after native tissue repair, between 17% and 22% will be aware of prolapse after permanent mesh repair. Rates of repeat surgery for prolapse were lower in the mesh group (RR 0.71, 95% CI 0.53 to 0.95; I2 = 35%; 17 studies, 2485 women; moderate-certainty evidence). There was no evidence of a difference between the groups in rates of repeat surgery for incontinence (RR 1.03, 95% CI 0.67 to 1.59; I2 = 0%; 13 studies, 2206 women; moderate-certainty evidence). However, more women in the mesh group required repeat surgery for the combined outcome of prolapse, stress incontinence, or mesh exposure (RR 1.56, 95% CI 1.07 to 2.26; I2 = 54%; 27 studies, 3916 women; low-certainty evidence). This suggests that if 7.1% of women require repeat surgery after native tissue repair, between 7.6% and 16% will require repeat surgery after permanent mesh repair. The rate of mesh exposure was 11.8% and surgery for mesh exposure was 6.1% in women who had mesh repairs. Recurrent prolapse on examination was less likely after mesh repair (RR 0.42, 95% CI 0.32 to 0.55; I2 = 84%; 25 studies, 3680 women; very low-certainty evidence). Permanent transvaginal mesh was associated with higher rates of de novo stress incontinence (RR 1.50, 95% CI 1.19 to 1.88; I2 = 0%; 17 studies, 2001 women; moderate-certainty evidence) and bladder injury (RR 3.67, 95% CI 1.63 to 8.28; I2 = 0%; 14 studies, 1997 women; moderate-certainty evidence). There was no evidence of a difference between the groups in rates of de novo dyspareunia (RR 1.22, 95% CI 0.83 to 1.79; I2 = 27%; 16 studies, 1308 women; moderate-certainty evidence). There was no evidence of a difference in quality of life outcomes; however, there was substantial heterogeneity in the data. Transvaginal absorbable mesh versus native tissue repair There was no evidence of a difference between the two methods of repair at two years for the rate of awareness of prolapse (RR 1.05, 95% CI 0.77 to 1.44; 1 study, 54 women), rate of repeat surgery for prolapse (RR 0.47, 95% CI 0.09 to 2.40; 1 study, 66 women), or recurrent prolapse on examination (RR 0.53, 95% CI 0.10 to 2.70; 1 study, 66 women). The effect of either form of repair was uncertain for bladder-related outcomes, dyspareunia, and quality of life. Transvaginal biological graft versus native tissue repair There was no evidence of a difference between the groups at one to three years for the outcome awareness of prolapse (RR 1.06, 95% CI 0.73 to 1.56; I2 = 0%; 8 studies, 1374 women; moderate-certainty evidence), repeat surgery for prolapse (RR 1.15, 95% CI 0.75 to 1.77; I2 = 0%; 6 studies, 899 women; moderate-certainty evidence), and recurrent prolapse on examination (RR 0.96, 95% CI 0.71 to 1.29; I2 = 53%; 9 studies, 1278 women; low-certainty evidence). There was no evidence of a difference between the groups for dyspareunia or quality of life. Transvaginal permanent mesh versus any other permanent mesh or biological graft vaginal repair Sparse reporting of primary outcomes in both comparisons significantly limited any meaningful analysis.

Authors' conclusions: While transvaginal permanent mesh is associated with lower rates of awareness of prolapse, repeat surgery for prolapse, and prolapse on examination than native tissue repair, it is also associated with higher rates of total repeat surgery (for prolapse, stress urinary incontinence, or mesh exposure), bladder injury, and de novo stress urinary incontinence. While the direction of effects and effect sizes are relatively unchanged from the 2016 version of this review, the certainty and precision of the findings have all improved with a larger sample size. In addition, the clinical relevance of these data has improved, with 10 trials reporting 3- to 10-year outcomes. The risk-benefit profile means that transvaginal mesh has limited utility in primary surgery. Data on the management of recurrent prolapse are of limited quality. Given the risk-benefit profile, we recommend that any use of permanent transvaginal mesh should be conducted under the oversight of the local ethics committee in compliance with local regulatory recommendations. Data are not supportive of absorbable meshes or biological grafts for the management of transvaginal prolapse.

Trial registration: ClinicalTrials.gov NCT00566917 NCT001532257 NCT00321867 NCT01095692.

PubMed Disclaimer

Conflict of interest statement

EY, KB, CC, NH, ZC, SW, AM, and CM have no conflicts of interests to declare

Figures

1
1
1.3 Recurrent prolapse on examination (any compartment)
2
2
PRISMA flow diagram
3
3
Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
4
4
Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
5
5
1.1 Awareness of prolapse (0.5 to 7 years
6
6
1.2 Repeat surgery (0.5 to 7 years)
7
7
1.20 Any repeat surgery (0.5 to 7 years)
8
8
1.3 Recurrent prolapse on examination (any compartment)
9
9
1.6 Visceral injury
10
10
1.7 Mesh exposure
11
11
1.10 Bladder function: de novo stress urinary incontinence (0.5 to 7 years)
12
12
1.11 Bladder function: de novo urge incontinence or voiding dysfunction
13
13
1.12 Painful intercourse ‐ de novo dyspareunia
14
14
2.1 Awareness of prolapse (2 years)
15
15
2.2 Repeat surgery (2 years)
16
16
2.3 Recurrent prolapse on examination (any)
17
17
2.4 Recurrent prolapse on examination (anterior compartment)
18
18
2.5 Recurrent prolapse on examination (posterior compartment)
19
19
3.1 Awareness of prolapse (1 to 3 years)
20
20
3.2 Repeat surgery (1 to 2 years)
21
21
3.3 Recurrent prolapse on examination (any compartment)
22
22
3.4 Recurrent prolapse on examination (anterior compartment)
23
23
3.5 Recurrent prolapse on examination (posterior compartment)
24
24
3.16 Operating time (minutes
25
25
1.1 Awareness of prolapse (0.5 to 7 years)
26
26
1.2 Repeat surgery (0.5 to 7 years)
1.1
1.1. Analysis
Comparison 1: Transvaginal permanent mesh versus native tissue repair, Outcome 1: Awareness of prolapse (0.5 to 7 years)
1.2
1.2. Analysis
Comparison 1: Transvaginal permanent mesh versus native tissue repair, Outcome 2: Repeat surgery (0.5 to 7 years)
1.3
1.3. Analysis
Comparison 1: Transvaginal permanent mesh versus native tissue repair, Outcome 3: Recurrent prolapse on examination (any compartment)
1.4
1.4. Analysis
Comparison 1: Transvaginal permanent mesh versus native tissue repair, Outcome 4: Recurrent prolapse on examination (anterior compartment)
1.5
1.5. Analysis
Comparison 1: Transvaginal permanent mesh versus native tissue repair, Outcome 5: Recurrent prolapse on examination (posterior compartment)
1.6
1.6. Analysis
Comparison 1: Transvaginal permanent mesh versus native tissue repair, Outcome 6: Visceral injury
1.7
1.7. Analysis
Comparison 1: Transvaginal permanent mesh versus native tissue repair, Outcome 7: Mesh exposure
1.8
1.8. Analysis
Comparison 1: Transvaginal permanent mesh versus native tissue repair, Outcome 8: POP‐Q assessment
1.9
1.9. Analysis
Comparison 1: Transvaginal permanent mesh versus native tissue repair, Outcome 9: POP‐Q assessment Total Vaginal Length (TVL)
1.10
1.10. Analysis
Comparison 1: Transvaginal permanent mesh versus native tissue repair, Outcome 10: Bladder function: de novo stress urinary incontinence (0.5 to 7 years)
1.11
1.11. Analysis
Comparison 1: Transvaginal permanent mesh versus native tissue repair, Outcome 11: Bladder function: de novo urge incontinence or voiding dysfunction
1.12
1.12. Analysis
Comparison 1: Transvaginal permanent mesh versus native tissue repair, Outcome 12: Painful intercourse ‐ de novo dyspareunia
1.13
1.13. Analysis
Comparison 1: Transvaginal permanent mesh versus native tissue repair, Outcome 13: Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire 12 (PISQ‐12) (0‐48)
1.14
1.14. Analysis
Comparison 1: Transvaginal permanent mesh versus native tissue repair, Outcome 14: Quality of life
1.15
1.15. Analysis
Comparison 1: Transvaginal permanent mesh versus native tissue repair, Outcome 15: Quality of life (combined)
1.16
1.16. Analysis
Comparison 1: Transvaginal permanent mesh versus native tissue repair, Outcome 16: Patient Global Impression of Improvement (PGI‐I) (better or very much better)
1.17
1.17. Analysis
Comparison 1: Transvaginal permanent mesh versus native tissue repair, Outcome 17: Operating time (minutes)
1.18
1.18. Analysis
Comparison 1: Transvaginal permanent mesh versus native tissue repair, Outcome 18: Length of stay in hospital (days)
1.19
1.19. Analysis
Comparison 1: Transvaginal permanent mesh versus native tissue repair, Outcome 19: Blood transfusion
1.20
1.20. Analysis
Comparison 1: Transvaginal permanent mesh versus native tissue repair, Outcome 20: Any repeat surgery (0.5 to 7 years)
1.21
1.21. Analysis
Comparison 1: Transvaginal permanent mesh versus native tissue repair, Outcome 21: Awareness of prolapse (0.5 to 7 years) including trials at high risk of bias
1.22
1.22. Analysis
Comparison 1: Transvaginal permanent mesh versus native tissue repair, Outcome 22: Repeat surgery (0.5 to 7 years) including trials at high risk of bias
1.23
1.23. Analysis
Comparison 1: Transvaginal permanent mesh versus native tissue repair, Outcome 23: Recurrent prolapse on examination (any compartment) including trials at high risk of bias
1.24
1.24. Analysis
Comparison 1: Transvaginal permanent mesh versus native tissue repair, Outcome 24: Any repeat surgery (0.5 to 7 years) including trials at high risk of bias
2.1
2.1. Analysis
Comparison 2: Transvaginal absorbable mesh versus native tissue repair, Outcome 1: Awareness of prolapse (2 years)
2.2
2.2. Analysis
Comparison 2: Transvaginal absorbable mesh versus native tissue repair, Outcome 2: Repeat surgery (2 years)
2.3
2.3. Analysis
Comparison 2: Transvaginal absorbable mesh versus native tissue repair, Outcome 3: Recurrent prolapse on examination (any)
2.4
2.4. Analysis
Comparison 2: Transvaginal absorbable mesh versus native tissue repair, Outcome 4: Recurrent prolapse on examination (anterior compartment)
2.5
2.5. Analysis
Comparison 2: Transvaginal absorbable mesh versus native tissue repair, Outcome 5: Recurrent prolapse on examination (posterior compartment)
2.6
2.6. Analysis
Comparison 2: Transvaginal absorbable mesh versus native tissue repair, Outcome 6: Visceral injury
2.7
2.7. Analysis
Comparison 2: Transvaginal absorbable mesh versus native tissue repair, Outcome 7: Mesh exposure
2.8
2.8. Analysis
Comparison 2: Transvaginal absorbable mesh versus native tissue repair, Outcome 8: POP‐Q assessment
2.9
2.9. Analysis
Comparison 2: Transvaginal absorbable mesh versus native tissue repair, Outcome 9: POP‐Q assessment Total Vaginal Length (TVL)
2.10
2.10. Analysis
Comparison 2: Transvaginal absorbable mesh versus native tissue repair, Outcome 10: Bladder function: de novo stress urinary incontinence
2.11
2.11. Analysis
Comparison 2: Transvaginal absorbable mesh versus native tissue repair, Outcome 11: Bladder function: de novo urge incontinence or voiding dysfunction
2.12
2.12. Analysis
Comparison 2: Transvaginal absorbable mesh versus native tissue repair, Outcome 12: Painful intercourse ‐ de novo dyspareunia
2.13
2.13. Analysis
Comparison 2: Transvaginal absorbable mesh versus native tissue repair, Outcome 13: Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire 12 (PISQ‐12) (0‐48)
2.14
2.14. Analysis
Comparison 2: Transvaginal absorbable mesh versus native tissue repair, Outcome 14: Quality of life
2.15
2.15. Analysis
Comparison 2: Transvaginal absorbable mesh versus native tissue repair, Outcome 15: Patient Global Impression of Improvement (PGI‐I) (better or very much better)
2.16
2.16. Analysis
Comparison 2: Transvaginal absorbable mesh versus native tissue repair, Outcome 16: Operating time (minutes)
2.17
2.17. Analysis
Comparison 2: Transvaginal absorbable mesh versus native tissue repair, Outcome 17: Length of stay (days)
2.18
2.18. Analysis
Comparison 2: Transvaginal absorbable mesh versus native tissue repair, Outcome 18: Blood transfusion
3.1
3.1. Analysis
Comparison 3: Transvaginal biological graft versus native tissue repair, Outcome 1: Awareness of prolapse (1 to 3 years)
3.2
3.2. Analysis
Comparison 3: Transvaginal biological graft versus native tissue repair, Outcome 2: Repeat surgery (1 to 2 years)
3.3
3.3. Analysis
Comparison 3: Transvaginal biological graft versus native tissue repair, Outcome 3: Recurrent prolapse on examination (any compartment)
3.4
3.4. Analysis
Comparison 3: Transvaginal biological graft versus native tissue repair, Outcome 4: Recurrent prolapse on examination (anterior compartment)
3.5
3.5. Analysis
Comparison 3: Transvaginal biological graft versus native tissue repair, Outcome 5: Recurrent prolapse on examination (posterior compartment)
3.6
3.6. Analysis
Comparison 3: Transvaginal biological graft versus native tissue repair, Outcome 6: Visceral injury
3.7
3.7. Analysis
Comparison 3: Transvaginal biological graft versus native tissue repair, Outcome 7: Mesh exposure
3.8
3.8. Analysis
Comparison 3: Transvaginal biological graft versus native tissue repair, Outcome 8: POP‐Q assessment
3.9
3.9. Analysis
Comparison 3: Transvaginal biological graft versus native tissue repair, Outcome 9: POP‐Q assessment Total Vaginal Length (TVL)
3.10
3.10. Analysis
Comparison 3: Transvaginal biological graft versus native tissue repair, Outcome 10: Bladder function: de novo stress urinary incontinence
3.11
3.11. Analysis
Comparison 3: Transvaginal biological graft versus native tissue repair, Outcome 11: Bladder function: de novo urge incontinence or voiding dysfunction
3.12
3.12. Analysis
Comparison 3: Transvaginal biological graft versus native tissue repair, Outcome 12: Painful intercourse ‐ de novo dyspareunia
3.13
3.13. Analysis
Comparison 3: Transvaginal biological graft versus native tissue repair, Outcome 13: Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire 12 (PISQ‐12) (0‐48)
3.14
3.14. Analysis
Comparison 3: Transvaginal biological graft versus native tissue repair, Outcome 14: Quality of life
3.15
3.15. Analysis
Comparison 3: Transvaginal biological graft versus native tissue repair, Outcome 15: Patient Global Impression of Improvement (PGI‐I) (better or very much better)
3.16
3.16. Analysis
Comparison 3: Transvaginal biological graft versus native tissue repair, Outcome 16: Operating time (minutes)
3.17
3.17. Analysis
Comparison 3: Transvaginal biological graft versus native tissue repair, Outcome 17: Length of stay (days)
3.18
3.18. Analysis
Comparison 3: Transvaginal biological graft versus native tissue repair, Outcome 18: Blood transfusion
4.1
4.1. Analysis
Comparison 4: Transvaginal permanent mesh versus another vaginal mesh, Outcome 1: Awareness of prolapse
4.2
4.2. Analysis
Comparison 4: Transvaginal permanent mesh versus another vaginal mesh, Outcome 2: Repeat surgery
4.3
4.3. Analysis
Comparison 4: Transvaginal permanent mesh versus another vaginal mesh, Outcome 3: Recurrent prolapse on examination (any compartment)
4.4
4.4. Analysis
Comparison 4: Transvaginal permanent mesh versus another vaginal mesh, Outcome 4: Recurrent prolapse on examination (anterior compartment)
4.5
4.5. Analysis
Comparison 4: Transvaginal permanent mesh versus another vaginal mesh, Outcome 5: Recurrent prolapse on examination (posterior compartment)
4.6
4.6. Analysis
Comparison 4: Transvaginal permanent mesh versus another vaginal mesh, Outcome 6: Visceral injury
4.7
4.7. Analysis
Comparison 4: Transvaginal permanent mesh versus another vaginal mesh, Outcome 7: Mesh exposure
4.8
4.8. Analysis
Comparison 4: Transvaginal permanent mesh versus another vaginal mesh, Outcome 8: POP‐Q assessment
4.9
4.9. Analysis
Comparison 4: Transvaginal permanent mesh versus another vaginal mesh, Outcome 9: POP‐Q assessment Total Vaginal Length (TVL)
4.10
4.10. Analysis
Comparison 4: Transvaginal permanent mesh versus another vaginal mesh, Outcome 10: Bladder function: de novo stress urinary incontinence
4.11
4.11. Analysis
Comparison 4: Transvaginal permanent mesh versus another vaginal mesh, Outcome 11: Bladder function: de novo urge incontinence or voiding dysfunction
4.12
4.12. Analysis
Comparison 4: Transvaginal permanent mesh versus another vaginal mesh, Outcome 12: Painful intercourse ‐ de novo dyspareunia
4.13
4.13. Analysis
Comparison 4: Transvaginal permanent mesh versus another vaginal mesh, Outcome 13: Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire 12 (PISQ‐12) (0‐48)
4.14
4.14. Analysis
Comparison 4: Transvaginal permanent mesh versus another vaginal mesh, Outcome 14: Quality of life
4.15
4.15. Analysis
Comparison 4: Transvaginal permanent mesh versus another vaginal mesh, Outcome 15: Patient Global Impression of Improvement (PGI‐I) (better or very much better)
4.16
4.16. Analysis
Comparison 4: Transvaginal permanent mesh versus another vaginal mesh, Outcome 16: Operating time (minutes)
4.17
4.17. Analysis
Comparison 4: Transvaginal permanent mesh versus another vaginal mesh, Outcome 17: Length of stay (days)
4.18
4.18. Analysis
Comparison 4: Transvaginal permanent mesh versus another vaginal mesh, Outcome 18: Blood transfusion
5.1
5.1. Analysis
Comparison 5: Transvaginal permanent mesh versus biological graft vaginal repair, Outcome 1: Awareness of prolapse
5.2
5.2. Analysis
Comparison 5: Transvaginal permanent mesh versus biological graft vaginal repair, Outcome 2: Repeat surgery
5.3
5.3. Analysis
Comparison 5: Transvaginal permanent mesh versus biological graft vaginal repair, Outcome 3: Recurrent prolapse on examination (any compartment)
5.4
5.4. Analysis
Comparison 5: Transvaginal permanent mesh versus biological graft vaginal repair, Outcome 4: Recurrent prolapse on examination (anterior compartment)
5.5
5.5. Analysis
Comparison 5: Transvaginal permanent mesh versus biological graft vaginal repair, Outcome 5: Recurrent prolapse on examination (posterior compartment)
5.6
5.6. Analysis
Comparison 5: Transvaginal permanent mesh versus biological graft vaginal repair, Outcome 6: Visceral injury
5.7
5.7. Analysis
Comparison 5: Transvaginal permanent mesh versus biological graft vaginal repair, Outcome 7: Mesh exposure
5.8
5.8. Analysis
Comparison 5: Transvaginal permanent mesh versus biological graft vaginal repair, Outcome 8: POP‐Q assessment
5.9
5.9. Analysis
Comparison 5: Transvaginal permanent mesh versus biological graft vaginal repair, Outcome 9: POP‐Q assessment Total Vaginal Length (TVL)
5.10
5.10. Analysis
Comparison 5: Transvaginal permanent mesh versus biological graft vaginal repair, Outcome 10: Bladder function: de novo stress urinary incontinence
5.11
5.11. Analysis
Comparison 5: Transvaginal permanent mesh versus biological graft vaginal repair, Outcome 11: Bladder function: de novo urge incontinence or voiding dysfunction
5.12
5.12. Analysis
Comparison 5: Transvaginal permanent mesh versus biological graft vaginal repair, Outcome 12: Painful intercourse ‐ de novo dyspareunia
5.13
5.13. Analysis
Comparison 5: Transvaginal permanent mesh versus biological graft vaginal repair, Outcome 13: Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire 12 (PISQ‐12) (0‐48)
5.14
5.14. Analysis
Comparison 5: Transvaginal permanent mesh versus biological graft vaginal repair, Outcome 14: Quality of life
5.15
5.15. Analysis
Comparison 5: Transvaginal permanent mesh versus biological graft vaginal repair, Outcome 15: Patient Global Impression of Improvement (PGI‐I) (better or very much better)
5.16
5.16. Analysis
Comparison 5: Transvaginal permanent mesh versus biological graft vaginal repair, Outcome 16: Operating time (minutes)
5.17
5.17. Analysis
Comparison 5: Transvaginal permanent mesh versus biological graft vaginal repair, Outcome 17: Length of stay (days)
5.18
5.18. Analysis
Comparison 5: Transvaginal permanent mesh versus biological graft vaginal repair, Outcome 18: Blood transfusion
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Update of

References

References to studies included in this review

Ahmed 2019 {published data only}
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Delroy 2013 {published data only}
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De Tayrac 2008 {published data only}
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De Tayrac 2013 {published data only}
    1. Allegre L, Callewaert G, Alonso S, Cornille A, Fernandez H, Eglin G, et al. Long-term outcomes of a randomized controlled trial comparing trans-obturator vaginal mesh with native tissue repair in the treatment of anterior vaginal wall prolapse. International Urogynecology Journal and Pelvic Floor Dysfunction 2020;31(4):745-53. - PubMed
    1. De Tayrac R, Cornille A, Eglin G, Guilbaud O, Mansoor A, Alonso S, et al. Comparison between trans-obturator trans-vaginal mesh and traditional anterior colporrhaphy in the treatment of anterior vaginal wall prolapse: results of a French RCT. International Urogynecology Journal 2013;24:1651-61. - PubMed
Dietz 2020 {published data only}
    1. Dietz H P, Korda A, Rosamilia A, Pardey J, Shek K L, Wong V, et al. Hiatal reduction with the 'puborectalis sling': a multicentre randomised controlled trial. International Urogynecology Journal 2020;31(Suppl 1):S3-4.
Feldner 2010 {published data only}
    1. Feldner PC Jr, Castro RA, Cipolotti LA, Delroy CA, Sartori MG, Girao MJ. Anterior vaginal wall prolapse: a randomized controlled trial of SIS graft versus traditional colporrhaphy. International Urogynecology Journal and Pelvic Floor Dysfunction 2010;21(9):1057-63. [40053] - PubMed
    1. Feldner PC Jr, Castro RA, Delroy CA, Dias MM, Sartori MG, Girao MJ. Surgical treatment of anterior vaginal wall prolapse: comparison of small intestine submucosa (SIS) graft and traditional repair (Abstract number 160). International Urogynecology Journal 2009;20 Suppl 2:S208-9. [39890]
Galad 2020 {published data only}
    1. Galad J, Papcun P, Dudic R, Urdzik P. Single incision mesh vs sacrospinous ligament fixation in post hysterectomy women at a three-year follow-up: a randomized trial. Bratislavske Lekarske Listy 2020;121(9):640-7. - PubMed
Gandhi 2005 {published data only}
    1. Gandhi S, Goldberg RP, Kwon C, Koduri S, Beaumont JL, Abramov Y, et al. A prospective randomized trial using solvent dehydrated fascia lata for the prevention of recurrent anterior vaginal wall prolapse. American Journal of Obstetrics and Gynecology 2005;192:1649-54. - PubMed
    1. Gandhi S, Kwon C, Goldberg RP, Abramov Y, Beaumont JL, Koduri S, et al. A randomized controlled trial of fascia lata for the prevention of recurrent anterior vaginal wall prolapse. Neurourology and Urodynamics 2004;23(5/6):558.
    1. Kwon C, Goldberg R, Evaston IL, Koduri S, Franklin WI, Gandhi S, et al. Preliminary results of a prospective randomized trial of tutoplast processed fascia lata to prevent recurrent cystoceles and rectoceles. The Journal of Urology 2002;167:203.
Glazener 2017 {published data only}
    1. Glazener CM, Breeman S, Elders A, Hemming C, Cooper KG, Freeman RM, et al. Mesh, graft, or standard repair for women having primary transvaginal anterior or posterior compartment prolapse surgery: two parallel-group, multicentre, randomised, controlled trials (PROSPECT). Lancet 2017;389(10067):381-92. [DOI: 10.1016/S0140-6736(16)31596-3] - DOI - PubMed
Glazener 2020 {published data only}
    1. Glazener C, Breeman S, Elders A, Hemming C, Cooper K G, Freeman R M, et al. Mesh inlay, mesh kit or native tissue repair for women having repeat anterior or posterior prolapse surgery: randomised controlled trial (PROSPECT). BJOG 2020;127(8):1002-13. - PubMed
Guerette 2009 {published data only}
    1. Guerette NL, Aguirre O, VanDrie DM, Biller DH, Davila GW. Multi-center, randomized, prospective trial comparing anterior colporrhaphy alone to bovine pericardium collagen matrix graft reinforced anterior colporrhaphy: 12-month analysis (Abstract number 11). International Urogynecology Journal and Pelvic Floor Dysfunction 2006;17 Suppl 2:63-4.
    1. Guerette NL, Peterson TV, Aguirre OA, VanDrie DM, Biller DH, Davila GW. Anterior repair with or without collagen. Obstetrics and Gynecology 2009;114:59-65. - PubMed
Gupta 2014 {published data only}
    1. Gupta B, Vaid NB, Suneja A, Guleria K, Jain S. Anterior vaginal prolapse repair: A randomised trial of traditional anterior colporrhaphy and self-tailored mesh repair. South African Journal of Obstetrics and Gynaecology 2014;20(3):47-50.
Halaska 2012 {published data only}
    1. Halaska M, Maxova K, Sottner O, Svabik K, Mlcoch M, Kolarik D, et al. A multicentre randomized prospective controlled study comparing sacrospinous fixation and transvaginal mesh in the treatment of post-hysterectomy vaginal vault prolapse. American Journal of Obstetrics and Gynecology 2012;207(301):e1-7. - PubMed
Hviid 2010 {published data only}
    1. Hviid U, Hviid TV, Rudnicki M. Porcine skin collagen implants for anterior vaginal wall prolapse: a randomised prospective controlled study. International Urogynecology Journal 2010;21(5):529-34. [39449] - PubMed
Iglesia 2010 {published data only}
    1. Gutman R, Nosti P, Sokol A, Sokol E, Peterson J, Wang H, Iglesia C. Three-year outcome of vaginal mesh for prolapse, a randomized controlled trial. Obstetrics & Gynecology 2013;122(4):770-7. [CLINICALTRIALS.GOV: NCT00475540] - PubMed
    1. Iglesia CB, Sokol AI, Sokol ER, Kudish BI. Vaginal mesh for prolapse: a randomized controlled trial. Obstetrics and Gynecology 2010;116(2 Pt 1):293-303. [39891] - PubMed
    1. Sokol AI, Iglesia CB, Kudish BI, Gutman RE, Shveiky D, Bercik R, et al. One-year objective and functional outcomes of a randomized clinical trial of vaginal mesh for prolapse. American Journal of Obstetrics and Gynecology 2012;206(1):86.e1-9. [DOI: 10.1016/j.ajog.2011.08.003] [42158] - DOI - PubMed
Iyer 2019 {published data only}
    1. Iyer S, Seitz M, Tran A, Scalabrin Reis R, Botros C, Lozo S, et al. Anterior colporrhaphy with and without dermal allograft: a randomized control trial with long-term follow-up. Female Pelvic Medicine & Reconstructive Surgery 2019;25(3):206-12. - PubMed
Lamblin 2014 {published data only}
    1. Lamblin G, Van-Nieuwenhuyse A, Chabert P, Lebail-Carval K, Moret S, Mellier G. A randomized controlled trial comparing anatomical and functional outcome between vaginal colposuspension and transvaginal mesh. International Urogynecology Journal 2014;25:961–70. - PubMed
Menefee 2011 {published data only}
    1. Dyer K, Nguyen J, Lukacz E, Simsiman A, Luber K, Menefee S. The Optimal Anterior Repair Study (OARS): a triple arm randomized double blinded clinical trial of standard colporrhaphy, porcine dermis or polypropylene mesh augmented anterior vaginal wall repair (Abstract number 252). Neurourology and Urodynamics 2009;28(7):894-5. [39346]
    1. Dyer K, Nguyen J, Simsiman A, Lukacz E, Luber K, Menefee S. The Optimal Anterior Repair Study (OARS): a triple arm randomized double blinded clinical trial of standard colporrhaphy versus vaginal paravaginal repair with porcine dermis graft or polypropylene mesh (Abstract number 281). Neurourology and Urodynamics 2010;29(6):1207-8. [40164]
    1. Menefee SA, Dyer KY, Lukacz ES, Simsiman AJ, Luber KM, Nguyen JN. Colporrhaphy compared with mesh or graft-reinforced vaginal paravaginal repair for anterior vaginal wall prolapse: a randomized controlled trial. Obstetrics and Gynecology 2011;118(6):1337-44. [42866] - PubMed
Meschia 2007 {published and unpublished data}
    1. Kocjancic E, Crivellaro S, Bernasconi F, Magatti F, Frea B, Meschia M. A two years follow-up, prospective randomized study on cystocele repair with or without Pelvicol (trademark) implant (Abstract number 1374). In: Proceedings of the Annual Meeting of the American Urological Association, 19-24 May 2007, Anaheim (CA). 2007.
    1. Meschia M, Pifarotti P, Bernasconi F, Magatti F, Riva D, Kojancic E. Porcine skin collagen implants to prevent anterior vaginal wall prolapse recurrence: A multicentre, randomized study. The Journal of Urology 2007;177:192-5. - PubMed
    1. Meschia M, Pifarotti P, Magatti F, Bernasconi F, Riva D, Kojancic E. Porcine skin collagen implants (Pelvicol) (trademark) to prevent anterior vaginal wall prolapse recurrence: a randomized study (Abstract). Neurourology and Urodynamics 2005;24(5/6):587-8.
Nager 2019 {published data only}
    1. Nager C W, Visco A G, Richter H E, Rardin C R, Komesu Y, Harvie H S, et al. Effect of sacrospinous hysteropexy with graft vs vaginal hysterectomy with uterosacral ligament suspension on treatment failure in women with uterovaginal prolapse: 5-year results of a randomized clinical trial. JAMA 2021;225(2):153.e1-153.e31. - PMC - PubMed
    1. Nager C W, Visco A G, Richter H E, Rardin C R, Rogers R G, Harvie H S, et al. Effect of vaginal mesh hysteropexy vs vaginal hysterectomy with uterosacral ligament suspension on treatment failure in women with uterovaginal prolapse: a randomized clinical trial [Erratum published in: Error in results section. JAMA. 2021;325(7):696. d. American Journal of Obstetrics and Gynecology 2019;322(11):1054-65. - PMC - PubMed
Nguyen 2008 {published and unpublished data}
    1. Nguyen JN, Burchette RJ. Anatomy and visceral function after anterior vaginal prolapse repair: a randomized controlled trial (Abstract number 42). In: Proceedings of the 29th Annual Meeting of the American Urogynecologic Society (AUGS), Sept 4-6, Chicago. 2008.
    1. Nguyen JN, Burchette RJ. Outcome after anterior vaginal prolapse repair. Randomized controlled trial. Obstetrics and Gynecology 2008;111(4):891-8. - PubMed
Nieminen 2008 {published data only}
    1. Hiltunen R, Nieminen K, Takala T, Heiskanen E, Merikari M, Niemi K, et al. Low-weight polypropylene mesh for anterior vaginal wall prolapse: a randomized controlled trial. Obstetrics and Gynecology 2007;110(2 pt 2):455-62. - PubMed
    1. Nieminen K, Hiltunen R, Heiskanen E, Takala T, Niemi K, Merikari M, et al. Symptom resolution and sexual function after anterior vaginal wall repair with or without polypropylene mesh. International Urogynecology Journal. 2008;19(12):1611-6. - PubMed
    1. Nieminen K, Hiltunen R, Takala T, Heiskanen E, Merikari M, Niemi K, et al. Outcomes after anterior vaginal wall repair with mesh: a randomized, controlled trial with a 3 year follow-up. American Journal of Obstetrics and Gynecology 2010;203(3):235.e1-8. [40020] - PubMed
Ouyang 2020 {published data only}
    1. Ouyang Y, Chen R, Chu L, Liang J, Zhang X, Li L, et al. Safety and efficacy of a self-developed Chinese pelvic repair system and Avaulta repair system for the treatment of pelvic organ prolapse in women: a multicenter, prospective, randomized, parallel-group study. Medicine 2020;99(38):e22332. - PMC - PubMed
Paraiso 2006 {published data only}
    1. Paraiso M, Barber M, Muir T, Walters M. Rectocele repair: A randomized trial of three surgical techniques including graft augmentation. American Journal of Obstetrics and Gynecology 2006;195:1762-71. - PubMed
Qatawneh 2013 {published data only}
    1. Qatawneh A, Al-Kazaleh F, Saleh S, Thekrallah F, Bata M, Sumreen I, et al. Transvaginal cystocele repair using tension-free polypropylene mesh at the time of sacrospinous colpopexy for advanced uterovaginal prolapse: a prospective randomised study. Gynecological Surgery 2013;10:79-85.
Robert 2014 {published data only}
    1. Robert M, Girard I, Brennand E, Tang S, Birch C, Murphy M, et al. Absorbable mesh augmentation compared with no mesh for anterior prolapse: a randomized controlled trial. Obstetrics and Gynecology 2014;123(2 Part 1):288-94. - PubMed
Rudnicki 2014 {published data only}
    1. Rudnicki M, Laurikainen E, Pogosean R, Kinne I, Jakobsson U, Teleman P. A 3–year follow-up after anterior colporrhaphy compared with collagen-coated transvaginal mesh for anterior vaginal wall prolapse: a randomised controlled trial. BJOG 2015;published online:1-7. - PubMed
    1. Rudnicki M, Laurikainen E, Pogosean R, Kinne I, Jakobsson U, Teleman P. Anterior colporrhaphy compared with collagen-coated transvaginal mesh for anterior vaginal wall prolapse: a randomised controlled trial. BJOG 2014;121:102-11. - PubMed
Sand 2001 {published data only}
    1. Goldberg RP, Koduri S, Lobel RW, Culligan PJ, Tomezsko JE, Winkler HA, et al. Long-term effects of three different anti-incontinence procedures on the posterior compartment (Abstract). In: Proceedings of the International Continence Society (ICS) 31st Annual Meeting; 2001 Sept 18-21; Seoul, Korea. 2001.
    1. Sand PK, Koduri S, Lobel RW, Winkler HA, Tomezsko J, Culligan PJ, et al. Prospective randomized trial of polyglactin 910 mesh to prevent recurrence of cystoceles and rectoceles. American Journal of Obstetrics and Gynecology 2001;184(7):1357-64. - PubMed
Shaher 2020 {published data only}
    1. Shaher S H, Soliman Othman T. Surgeon tailored transobturator four arms mesh versus anterior colporrhaphy in the surgical management of cystocele accompanied by stress urinary incontinence (Abstract number 1083). European Urology 2020;19(Suppl 2):e1612.
Sivaslioglu 2008 {published data only}
    1. Sivaslioglu AA, Unlubilgin E, Dolen I. A randomized comparison of polypropylene mesh surgery with site-specific surgery in the treatment of cystocoele. International Urogynecology Journal. 2008;19(4):467-71. - PubMed
Steures 2019 {published data only}
    1. Steures P, Milani A L, Rumpt-van de Geest D A, Kluivers K B, Withagen M I J. Partially absorbable mesh or native tissue repair for pelvic organ prolapse: a randomized controlled trial. International Urogynecology Journal and Pelvic Floor Dysfunction 2019;30(4):565-73. - PMC - PubMed
Sung 2012 {published data only}
    1. Sung VW, Rardin CR, Raker CA, Lasala CA, Myers DL. Porcine subintestinal submucosal graft augmentation for rectocele repair: a randomized controlled trial. Obstetrics and Gynecology 2012;119(1):125-33. [42876] - PMC - PubMed
Svabik 2014 {published data only}
    1. Svabik K, Martan A, Masata J, El-Haddad R, Hubka P. Comparison of vaginal mesh repair with sacrospinous vaginal colpopexy in the management of vaginal vault prolapse after hysterectomy in patients with levator ani avulsion: a randomized controlled trial. Ultrasound in Obstetrics and Gynecology 2014;43(4):365-71. - PubMed
Takeyama 2020 {published data only}
    1. Takeyama M, Kuwata T, Kashihara H, Kato C. Is trans-vaginal mesh procedure using polytetrafluoroethylene(PTFE) mesh ORIHIME® feasible for the anterior vaginal prolapse repair?-comparative study between PTFE mesh and polypropylene mesh up to 1 year. International Urogynecology Journal 2020;31(SUPPL 1):S171.
Tamanini 2014 {published data only}
    1. Tamanini J T N, Reis L O, da Mota Tamanini M M, Aquino Castro R, Sartori M G F, Girao Mjbc. No mesh versus mesh in the treatment of anterior vaginal wall prolapse: prospective, randomised, controlled trial, long-term follow-up. International Urology and Nephrology 2020;52(10):1839-44. - PubMed
    1. Tamanini JTN, Oliveira Souza Castro RC, Tamanini JM, Castro RA, Sartori MGF, Girão MJBC. A prospective, randomized and controlled trial for the treatment of anterior vaginal wall prolapse: medium-term follow-up. The Journal of Urology 2015;193(4):1298-304. - PubMed
    1. Tamanini JTN, Oliveira Souza Castro RC, Tamanini JM, Castro RA, Sartori MGF, Girão MJBC. Treatment of anterior vaginal wall prolapse with and without polypropylene mesh: a prospective, randomized and controlled trial - Part I. Int Braz J Urol 2013;39(4):519-30. - PubMed
Thijs 2010 {published data only}
    1. Thijs S, Deprest J, De Ridder D, Claerhout F, Roovers J. A randomized controlled trial of anterior colporraphy and Perigee™ as a primary surgical correction of symptomatic cystocele (Abstract number 96). International Urogynecology Journal and Pelvic Floor Dysfunction 2010;21 Suppl 1:S142-3. [40133]
Turgal 2013 {published data only}
    1. Turgal M, Sivaslioglu A, Yildiz A, Dolen I. Anatomical and functional assessment of anterior colporrhaphy versus polypropylene mesh surgery in cystocele treatment. European Journal of Obstetrics and Gynecology and Reproductive Biology 2013;170(2):555-8. - PubMed
Vollebregt 2011 {published data only}
    1. Vollebregt A, Fischer K, Gietelink D, Vaart CH. Primary surgical repair of anterior vaginal prolapse: a randomised trial comparing anatomical and functional outcome between anterior colporrhaphy and trocar-guided transobturator anterior mesh. British Journal of Obstetrics and Gynaecology 2011;118(12):1518-27. [42606] - PubMed
    1. Vollebregt A, Gietelink D, Fischer K, Vaart H. One year results of colporrhaphy anterior versus a trocar guided transobturator synthetic mesh in primary cystocele repair: a randomized controlled trial (Abstract number 51). Neurourology and Urodynamics 2010;29(6):880-2. [40124]
Weber 2001 {published data only}
    1. Weber AM, Walters MD, Piedmonte MR, Ballard LA. Anterior colporrhaphy: a randomized trial of three surgical techniques. American Journal of Obstetrics and Gynecology 2001;185(6 Pt 1):1299-306. - PubMed
Wei 2019 {published data only}
    1. Wei A M, Fan Y, Zhang L, Shen Y F, Kou Q, Tan X M. Evaluation of Clinical Outcome and Risk Factors for Recurrence after Pelvic Reconstruction of Pelvic Organ Prolapse with Implanted Mesh or Biological Grafts: A Single-Blind Randomized Trial. Gynecologic and Obstetric Investigation 2019;84(5):503-11. - PubMed
Withagen 2011 {published and unpublished data}
    1. Milani A L, Damoiseaux A, IntHout J, Kluivers K B, Withagen M I J. Long-term outcome of vaginal mesh or native tissue in recurrent prolapse: a randomized controlled trial. International Urogynecology Journal and Pelvic Floor Dysfunction 2018;29(6):847-58. - PMC - PubMed
    1. Milani AL, Withagen MI, The HS, Nedelcu-Van der Wijk I, Vierhout ME. Sexual function following trocar-guided mesh or vaginal native tissue repair in recurrent prolapse: A randomized controlled trial. The Journal of Sexual Medicine 2011;8(10):2944-53. [42064] - PubMed
    1. Withagen MI, Milani AL, Boon Den J, Vervest HA, Vierhout ME. Tension free vaginal mesh compared to conventional vaginal prolapse surgery in recurrent prolapse; a randomized controlled trial (Abstract number 090). International Urogynaecology Journal 2009;20 Suppl 2:S153-4. [39885]
    1. Withagen MI, Milani AL, den Boon J, Vervest HA, Vierhout ME. Trocar-guided mesh compared with conventional vaginal repair in recurrent prolapse: a randomized controlled trial. Obstetrics and Gynecology 2011;117(2 Pt 1):242-50. [40881] - PubMed
Yang 2016 {published data only}
    1. Yang X-H, Zhao Z-Y. Prolift mesh versus polypropylene mesh in the whole pelvic floor reconstruction. Chinese Journal of Tissue Engineering Research 2016;20(34):5122-8.

References to studies excluded from this review

Ali 2006 {published data only}
    1. Ali S, Han HC, Lee LC. A prospective randomized trial using Gynemesh PS (trademark) for the repair of anterior vaginal wall prolapse (Abstract number 292). International Urogynecology Journal and Pelvic Floor Dysfunction 2006;17 Suppl 2:221.
Altman 2013 {published data only}
    1. Altman D, Mooller Bek K, Mikkola T, Gunnarsson J, Ellstrom Engh M, Falconer C. Intra-and perioperative morbidity following pelvic organ prolapse repair using a transvaginal suture capturing mesh device compared to trocar guided transvaginal mesh and traditional colporraphy. Neurourology and Urodynamics 2013;32(6):873-4.
Balci 2011 {published data only}
    1. Balci O, Capar M, Acar A, Colakoglu MC. Balci technique for suspending vaginal vault at vaginal hysterectomy with reduced risk of vaginal vault prolapse. Journal of Obstetrics and Gynaecology Research 2011;37(7):762-9. - PubMed
Chao 2012 {published data only}
    1. Chao FL, Rosamilia A, Dwyer PL, Polyakov A, Schierlitz L, Agnew G. Does pre-operative traction on the cervix approximate intra-operative uterine prolapse? A randomised controlled trial. International Urogynecology Journal 2012;23(4):417-22. - PubMed
Juneja 2010 {published data only}
    1. Juneja M, Munday D, Kopetz V, Barry C. Hysterectomy vs no hysterectomy for uterine prolapse in conjunction with posterior infracococcygeal colpopexy - a randomised pilot study 12 months review (Abstract number 692). In: Proceedings of the Joint Meeting of the International Continence Society (ICS) and the International Urogynecological Association, 2010 Aug 23-27, Toronto, Canada. 2010.
Lukacz 2020 {published data only}
    1. Lukacz ES, Sridhar A, Chermansky CJ, Rahn DD, Harvie HS, Gantz MG, et al. Sexual activity and dyspareunia 1 year after surgical repair of pelvic organ prolapse. Obstetrics and Gynecology 2020;136(3):492-500. - PMC - PubMed
Meschia 2004 {published and unpublished data}
    1. Meschia M, Gattei U, Pifarotti P, Spennacchio M, Longatti D, Barbacini P. Randomized comparison between infracoccygeal sacropexy (posterior IVS) and sacrospinous fixation in the management of vault prolapse (Abstract number 614). In: Proceedings of the Joint Meeting of the International Continence Society (34th Annual Meeting) and the International Urogynecological Association, 2004 Aug 23-27, Paris. 2004.
NCT00743535 {published data only}
    1. NCT00743535. Anterior defect correction with mesh plus treatment of stress incontinence with transobturator or transvaginal approach. http://ClinicalTrials.gov/show/NCT00743535 (first posted 28 August 2008).
NCT01497171 {unpublished data only}
    1. NCT01497171. The ELEGANT Trial: Elevate transvaginal mesh vs. anterior colporrhaphy. http://ClinicalTrials.gov/show/NCT01497171 (first posted 20 December 2011).
NCT01594372 {unpublished data only}
    1. NCT01594372. Comparison laparoscopic to vaginal surgery for uterine prolapse. http://ClinicalTrials.gov/show/NCT01594372 (first posted 4 May 2012).
Reid 2021 {published data only}
    1. Reid FM, Elders A, Breeman S, Freeman RM, Prospect study group. How common are complications following polypropylene mesh, biological xenograft and native tissue surgery for pelvic organ prolapse? A secondary analysis from the PROSPECT trial. BJOG 2021;128(13):2180-2189. [DOI: 10.1111/1471-0528.16897] - DOI - PMC - PubMed
Tincello 2009 {published data only}
    1. Tincello DG, Kenyon S, Slack M, Toozs-Hobson P, Mayne C, Jones D, et al. Colposuspension or TVT with anterior repair for urinary incontinence and prolapse: results of and lessons from a pilot randomised patient-preference study (CARPET 1). British Journal of Obstetrics and Gynaecology 2009;116(13):1809-14. - PubMed
    1. Tincello DG, Mayne CJ, Toozs-Hobson P, Slack M. Randomised controlled trial of colposuspension versus anterior repair plus TVT for urodynamic stress incontinence with anterior vaginal prolapse: proposal (Abstract). In: Proceedings of the International Continence Society, 11th Annual Scientific Meeting; 2004 Mar 18-19; Bournemouth, United Kingdom. 2004:46. [17170]
Wallace 2021 {published data only}
    1. Wallace S, Syan R, Lee K, Sokol E. Cost-effectiveness of transvaginal hysteropexy compared to vaginal hysterectomy with apical suspension for the treatment of pelvic organ prolapse: a 5-year markov model. Neurourology and Urodynamics 202140;40(SUPPL 1):S65-7.

References to ongoing studies

NCT00955448 {published data only}
    1. NCT00955448. Trial of small intestine submucosa (SIS) mesh for anterior repair. https://clinicaltrials.gov/show/NCT00955448 (first posted 5 August 2009).
NCT01095692 {published data only}
    1. NCT01095692. Evaluating the necessity of TOT implantation in women with pelvic organ prolapse and occult stress urinary incontinence (ATHENA). http://clinicaltrials.gov/ct2/show/NCT01095692 (first posted 29 March 2010). [41350]

Additional references

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Adams 2004
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Bump 1998
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Crosby 2014
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Deprest 2022
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FDA 2024
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Gill 1998
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Glazener 2020
    1. Glazener C, Breeman S, Elders A, Hemming C, Cooper K G, Freeman R M, et al. Mesh inlay, mesh kit or native tissue repair for women having repeat anterior or posterior prolapse surgery: randomised controlled trial (PROSPECT). Lancet 2020;127(8):1002-13. - PubMed
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