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Review
. 2024 Dec 10;6(1):e464.
doi: 10.1002/bco2.464. eCollection 2025 Jan.

Systematic review and meta-analysis of the pelvic organ prolapse and vaginal prolapse among the global population

Tharanga Mudalige  1 , Vindya Pathiraja  1 , Gayathri Delanerolle  2   3 , Heitor Cavalini  2 , Shuqi Wu  4 , Julie Taylor  3 , Om Kurmi  5 , Kathryn Elliot  2 , Sharron Hinchliff  6 , Carol Atkinson  6   7 , Kristina Potocnik  8 , Paula Briggs  9   10 , Lucky Saraswat  11 , Helen Felicity Kemp  12 , George Eleje  13 , Toh Teck Hock  14 , Cristina Laguna Benetti-Pinto  15 , Irfan Muhammad  16 , Rabia Kareem  16 , Yassine Bouchareb  17 , Peter Phiri  2   4 , Ruishu Zhang  17 , Yunfei Weng  17 , Ieera Aggarwal  18 , Jian Qing Shi  2   17   19 , Ashish Shetty  1   20   21 , Ian Litchfield  3 , Nirmala Rathnayake  7 , Sohier Elneil  21   22
Affiliations
Review

Systematic review and meta-analysis of the pelvic organ prolapse and vaginal prolapse among the global population

Tharanga Mudalige et al. BJUI Compass. .

Abstract

Background: Pelvic organ prolapse (POP) occurs when one or more pelvic organs (uterus, bowel, bladder or top of the vagina) descend from their normal position and bulge into the vagina. Symptoms include pelvic discomfort, fullness, and changes in bladder or bowel function. Treatment ranges from conservative approaches to surgery, depending on symptom severity. Surgical methods include vaginal wall repair, with or without hysterectomy, or via laparoscopic, robotic or open techniques. Common complications include bleeding, infection, and urinary or bowel dysfunction.

Methods: A systematic review was conducted, and a protocol was registered with PROSPERO (CRD42022346051). Publications from 30 April 1980 to 30 April 2023 were retrieved from multiple databases. Data were analysed using random-effects and common-effects models with subgroup and sensitivity analyses.

Findings: Forty-four studies met the inclusion criteria, with 29 studies used for meta-analysis of vaginal prolapse surgery outcomes. Sixteen studies focused on patients who had undergone hysterectomy alongside prolapse repair.

Interpretation: Patients who underwent vaginal prolapse surgery with hysterectomy experienced higher operative and postoperative complication rates than those without hysterectomy. Increased risks included hospital readmission, POP recurrence and re-operation. The review highlighted a lack of diversity in terms of ethnicity, age and comorbidity status, which are essential to fully understanding the impact of POP. Future research should focus on these underrepresented factors.

Keywords: gynaecology; pelvic organ prolapse; urology; wellbeing; women's health.

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Conflict of interest statement

All authors report no conflict of interest. The views expressed are those of the authors and not necessarily those of the NHS, the National Institute for Health Research, the Department of Health and Social Care or the academic institutions.

Figures

FIGURE 1
FIGURE 1
PRISMA flow diagram.
FIGURE 2
FIGURE 2
Forest plot showing the log odds of bladder injury among pelvic organ prolapse (POP) women that have had a hysterectomy.
FIGURE 3
FIGURE 3
Forest plot showing the log odds of infections among pelvic organ prolapse (POP) women that have had a hysterectomy.
FIGURE 4
FIGURE 4
Forest plot showing the log odds of mesh complications among pelvic organ prolapse (POP) women that have had a hysterectomy.
See this image and copyright information in PMC

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