What do systematic reviews say?

Vaginal hysterectomy vs vaginal hysteropexy (uterine prolapse)

• Surgery for women with apical vaginal prolapse 2023 · Cochrane Headline outcomes only
  no estimate extracted
  3 studies · 413 participants
  Low

Vaginal hysterectomy vs vaginal hysteropexy (uterine prolapse)

Vaginal hysterectomy showed no clear difference in bladder function ‐ Stress incontinence compared with vaginal hysteropexy (uterine prolapse) (low certainty).

• Surgery for women with apical vaginal prolapse 2023 · Cochrane Headline outcomes only
  OR 0.51 [0.22, 1.17]
  1 study · 175 participants
  Low

Vaginal hysterectomy vs vaginal hysteropexy (uterine prolapse)

Vaginal hysterectomy showed no clear difference in painful intercourse ‐ Dyspareunia compared with vaginal hysteropexy (uterine prolapse) (low certainty).

• Surgery for women with apical vaginal prolapse 2023 · Cochrane Headline outcomes only
  RR 0.53 [0.13, 2.11]
  2 studies · 331 participants
  Low

Vaginal hysterectomy vs vaginal hysteropexy (uterine prolapse)

• Surgery for women with apical vaginal prolapse 2023 · Cochrane Headline outcomes only
  no estimate extracted
  2 studies · 382 participants
  Low

Vaginal surgery with mesh vs non‐mesh repair

Vaginal surgery with mesh showed no clear difference in awareness of prolapse compared with without mesh (moderate certainty).

• Surgery for women with apical vaginal prolapse 2023 · Cochrane Headline outcomes only
  RR 1.08 [0.35, 3.3]
  1 study · 54 participants
  Moderate

Vaginal procedure vs sacral colpopexy (vault prolapse)

Vaginal procedure probably leads to higher prolapse on examination (Stage 2 or above) ‐ Any recurrent prolapse compared with sacral colpopexy (vault prolapse) (moderate certainty).

• Surgery for women with apical vaginal prolapse 2023 · Cochrane Headline outcomes only
  RR 1.87 [1.32, 2.65]
  5 studies · 422 participants
  Moderate

Vaginal surgery with mesh vs non‐mesh repair

Vaginal surgery with mesh showed no clear difference in surgery for recurrent prolapse compared with without mesh (moderate certainty).

• Surgery for women with apical vaginal prolapse 2023 · Cochrane Headline outcomes only
  RR 0.57 [0.3, 1.06]
  5 studies · 450 participants
  Moderate

Vaginal surgery with mesh vs non‐mesh repair

Vaginal surgery with mesh showed no clear difference in prolapse on examination (Stage 2 or above) ‐ Any recurrent prolapse compared with without mesh (low certainty).

• Surgery for women with apical vaginal prolapse 2023 · Cochrane Headline outcomes only
  RR 0.36 [0.09, 1.4]
  3 studies · 269 participants
  Low

Vaginal surgery with mesh vs non‐mesh repair

Vaginal surgery with mesh showed no clear difference in bladder injury compared with without mesh (low certainty).

• Surgery for women with apical vaginal prolapse 2023 · Cochrane Headline outcomes only
  RR 3 [0.91, 9.89]
  4 studies · 445 participants
  Low

Vaginal surgery with mesh vs non‐mesh repair

Vaginal surgery with mesh may leads to higher mesh exposure compared with without mesh (low certainty).

• Surgery for women with apical vaginal prolapse 2023 · Cochrane Headline outcomes only
  RR 14.75 [4.64, 46.89]
  5 studies · 499 participants
  Low

Vaginal surgery with mesh vs non‐mesh repair

Vaginal surgery with mesh showed no clear difference in bladder function ‐ Stress incontinence compared with without mesh (moderate certainty).

• Surgery for women with apical vaginal prolapse 2023 · Cochrane Headline outcomes only
  RR 1.37 [0.97, 1.93]
  6 studies · 463 participants
  Moderate

Vaginal surgery with mesh vs non‐mesh repair

• Surgery for women with apical vaginal prolapse 2023 · Cochrane Headline outcomes only
  no estimate extracted
  3 studies · 180 participants
  Moderate

Vaginal uterosacral colpopexy vs alternative vaginal native tissue apical suspension

Vaginal uterosacral colpopexy showed no clear difference in awareness of prolapse compared with alternative vaginal native tissue apical suspension (moderate certainty).

• Surgery for women with apical vaginal prolapse 2023 · Cochrane Headline outcomes only
  RR 0.88 [0.68, 1.15]
  1 study · 267 participants
  Moderate

Vaginal uterosacral colpopexy vs alternative vaginal native tissue apical suspension

Vaginal uterosacral colpopexy showed no clear difference in surgery for recurrent prolapse compared with alternative vaginal native tissue apical suspension (moderate certainty).

• Surgery for women with apical vaginal prolapse 2023 · Cochrane Headline outcomes only
  RR 1.86 [0.66, 5.28]
  1 study · 228 participants
  Moderate

Vaginal uterosacral colpopexy vs alternative vaginal native tissue apical suspension

Vaginal uterosacral colpopexy showed no clear difference in prolapse on examination ‐ Anterior compartment prolapse compared with alternative vaginal native tissue apical suspension (moderate certainty).

• Surgery for women with apical vaginal prolapse 2023 · Cochrane Headline outcomes only
  RR 1.14 [0.88, 1.48]
  3 studies · 588 participants
  Moderate

Vaginal uterosacral colpopexy vs alternative vaginal native tissue apical suspension

Vaginal uterosacral colpopexy showed no clear difference in prolapse on examination ‐ Apical compartment prolapse compared with alternative vaginal native tissue apical suspension (moderate certainty).

• Surgery for women with apical vaginal prolapse 2023 · Cochrane Headline outcomes only
  RR 0.8 [0.38, 1.67]
  3 studies · 587 participants
  Moderate

Vaginal procedure vs sacral colpopexy (vault prolapse)

Vaginal procedure showed no clear difference in intraoperative Visceral injury compared with sacral colpopexy (vault prolapse) (moderate certainty).

• Surgery for women with apical vaginal prolapse 2023 · Cochrane Headline outcomes only
  RR 0.46 [0.13, 1.63]
  7 studies · 625 participants
  Moderate

Vaginal uterosacral colpopexy vs alternative vaginal native tissue apical suspension

Vaginal uterosacral colpopexy showed no clear difference in prolapse on examination ‐ Posterior compartment prolapse compared with alternative vaginal native tissue apical suspension (moderate certainty).

• Surgery for women with apical vaginal prolapse 2023 · Cochrane Headline outcomes only
  RR 1.36 [0.79, 2.32]
  3 studies · 588 participants
  Moderate

Vaginal uterosacral colpopexy vs alternative vaginal native tissue apical suspension

Vaginal uterosacral colpopexy showed no clear difference in bladder function ‐ Stress urinary incontinence compared with alternative vaginal native tissue apical suspension (low certainty).

• Surgery for women with apical vaginal prolapse 2023 · Cochrane Headline outcomes only
  RR 1.6 [0.64, 3.98]
  1 study · 228 participants
  Low

Vaginal uterosacral colpopexy vs alternative vaginal native tissue apical suspension

Vaginal uterosacral colpopexy showed no clear difference in painful intercourse ‐ Dyspareunia compared with alternative vaginal native tissue apical suspension (low certainty).

• Surgery for women with apical vaginal prolapse 2023 · Cochrane Headline outcomes only
  RR 1.19 [0.73, 1.95]
  1 study · 228 participants
  Low