What do systematic reviews say?

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

Any transvaginal permanent mesh vs native tissue repair

Transvaginal permanent mesh probably leads to higher mesh exposure compared with native tissue repair (moderate certainty).

• Transvaginal mesh or grafts or native tissue repair for vaginal prolapse 2024 · Cochrane Headline outcomes only
  RR 11.1 [6.81, 18.1]
  26 studies · 2980 participants
  Moderate

Vaginal POP surgery with armed mesh vs anterior native tissue repair

Vaginal POP surgery with armed mesh may leads to higher one type of POP surgery vs another: armed anterior mesh vs anterior… compared with anterior native tissue repair (low certainty).

• Surgery for women with pelvic organ prolapse with or without stress urinary incontinence 2018 · Cochrane Headline outcomes only
  RR 1.58 [1.05, 2.37]
  7 studies · 905 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 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 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

Any transvaginal permanent mesh vs native tissue repair

Transvaginal permanent mesh probably leads to lower awareness of prolapse (0.5 to 7 years) compared with native tissue repair (moderate certainty).

• Transvaginal mesh or grafts or native tissue repair for vaginal prolapse 2024 · Cochrane Headline outcomes only
  RR 0.83 [0.73, 0.95]
  17 studies · 2932 participants
  Moderate

Any transvaginal permanent mesh vs native tissue repair

Transvaginal permanent mesh may leads to higher repeat surgery (0.5 to 7 years) compared with native tissue repair (low certainty).

• Transvaginal mesh or grafts or native tissue repair for vaginal prolapse 2024 · Cochrane Headline outcomes only
  RR 1.56 [1.07, 2.26]
  27 studies · 3916 participants
  Low

Any transvaginal permanent mesh vs native tissue repair

It is very uncertain whether transvaginal permanent mesh changes recurrent prolapse on examination (any compartment) compared with native tissue repair (very low certainty).

• Transvaginal mesh or grafts or native tissue repair for vaginal prolapse 2024 · Cochrane Headline outcomes only
  RR 0.42 [0.32, 0.55]
  25 studies · 3680 participants
  Very low

Any transvaginal permanent mesh vs native tissue repair

Transvaginal permanent mesh may leads to higher visceral injury compared with native tissue repair (low certainty).

• Transvaginal mesh or grafts or native tissue repair for vaginal prolapse 2024 · Cochrane Headline outcomes only
  RR 3.67 [1.63, 8.28]
  14 studies · 1997 participants
  Low

Any transvaginal permanent mesh vs native tissue repair

Transvaginal permanent mesh probably leads to higher bladder function compared with native tissue repair (moderate certainty).

• Transvaginal mesh or grafts or native tissue repair for vaginal prolapse 2024 · Cochrane Headline outcomes only
  RR 1.5 [1.19, 1.88]
  17 studies · 2001 participants
  Moderate

Any transvaginal permanent mesh vs native tissue repair

Transvaginal permanent mesh showed no clear difference in painful intercourse ‐ de novo dyspareunia compared with native tissue repair (moderate certainty).

• Transvaginal mesh or grafts or native tissue repair for vaginal prolapse 2024 · Cochrane Headline outcomes only
  RR 1.22 [0.83, 1.79]
  16 studies · 1308 participants
  Moderate

Any transvaginal permanent mesh vs native tissue repair

It is very uncertain whether transvaginal permanent mesh changes quality of life compared with native tissue repair (very low certainty).

• Transvaginal mesh or grafts or native tissue repair for vaginal prolapse 2024 · Cochrane Headline outcomes only
  no estimate extracted
  9 studies · 1365 participants
  Very low