What do systematic reviews say?

Absorbable vs non‐absorbable sutures

Absorbable showed no clear difference in awareness of prolapse compared with non absorbable sutures (moderate certainty).

• Surgery for women with apical vaginal prolapse 2023 · Cochrane Headline outcomes only
  RR 0.78 [0.39, 1.56]
  4 studies · 493 participants
  Moderate

Absorbable vs non‐absorbable sutures

Absorbable showed no clear difference in prolapse on examination ‐ Any recurrent prolapse compared with non absorbable sutures (high certainty).

• Surgery for women with apical vaginal prolapse 2023 · Cochrane Headline outcomes only
  RR 0.82 [0.48, 1.4]
  3 studies · 417 participants
  High

Absorbable vs non‐absorbable sutures

Absorbable showed no clear difference in visceral injury ‐ Bladder compared with non absorbable sutures (moderate certainty).

• Surgery for women with apical vaginal prolapse 2023 · Cochrane Headline outcomes only
  RR 0.43 [0.11, 1.65]
  3 studies · 545 participants
  Moderate

Absorbable vs non‐absorbable sutures

Absorbable showed no clear difference in suture/mesh exposure compared with non absorbable sutures (low certainty).

• Surgery for women with apical vaginal prolapse 2023 · Cochrane Headline outcomes only
  RR 0.25 [0.04, 1.6]
  5 studies · 688 participants
  Low

Absorbable vs non‐absorbable sutures

Absorbable showed no clear difference in painful intercourse ‐ Dyspareunia compared with non absorbable sutures (low certainty).

• Surgery for women with apical vaginal prolapse 2023 · Cochrane Headline outcomes only
  RR 0.11 [0, 3.91]
  2 studies · 161 participants
  Low

Sacral colpopexy: laparoscopic vs alternative approach

Sacral colpopexy: laparoscopic showed no clear difference in awareness of prolapse: Laparoscopic versus open compared with alternative approach (low certainty).

• Surgery for women with apical vaginal prolapse 2023 · Cochrane Headline outcomes only
  RR 2.06 [0.4, 10.54]
  2 studies · 193 participants
  Low

Vaginal procedure vs sacral colpopexy (vault prolapse)

Vaginal procedure probably leads to higher bladder Function ‐ Stress incontinence compared with sacral colpopexy (vault prolapse) (moderate certainty).

• Surgery for women with apical vaginal prolapse 2023 · Cochrane Headline outcomes only
  RR 1.86 [1.17, 2.94]
  3 studies · 263 participants
  Moderate

Sacral colpopexy: laparoscopic vs alternative approach

Sacral colpopexy: laparoscopic showed no clear difference in prolapse on examination (Stage 2 or more): Any recurrent prolapse compared with alternative approach (low certainty).

• Surgery for women with apical vaginal prolapse 2023 · Cochrane Headline outcomes only
  RR 1.29 [0.64, 2.56]
  3 studies · 225 participants
  Low

Sacral colpopexy: laparoscopic vs alternative approach

It is very uncertain whether sacral colpopexy: laparoscopic changes any complications (Clavien‐Dindo > 3) compared with alternative approach (very low certainty).

• Surgery for women with apical vaginal prolapse 2023 · Cochrane Headline outcomes only
  RR 1.26 [0.17, 9.44]
  2 studies · 193 participants
  Very low

Sacral colpopexy: laparoscopic vs alternative approach

• Surgery for women with apical vaginal prolapse 2023 · Cochrane Headline outcomes only
  no estimate extracted
  3 studies · 241 participants
  Very low

Sacral colpopexy: laparoscopic vs alternative approach

• Surgery for women with apical vaginal prolapse 2023 · Cochrane Headline outcomes only
  no estimate extracted
  3 studies · 246 participants
  Low

Vaginal procedure vs sacral colpopexy (vault prolapse)

Vaginal procedure showed no clear difference in painful intercourse ‐ Dyspareunia compared with sacral colpopexy (vault prolapse) (low certainty).

• Surgery for women with apical vaginal prolapse 2023 · Cochrane Headline outcomes only
  RR 3.44 [0.61, 19.53]
  3 studies · 106 participants
  Low

Vaginal procedure vs sacral colpopexy (vault prolapse)

• Surgery for women with apical vaginal prolapse 2023 · Cochrane Headline outcomes only
  no estimate extracted
  6 studies · 517 participants
  Low

Vaginal procedure vs sacral colpopexy (vault prolapse)

• Surgery for women with apical vaginal prolapse 2023 · Cochrane Headline outcomes only
  no estimate extracted
  2 studies · 188 participants
  Low

Vaginal hysterectomy vs sacral hysteropexy/cervicopexy (uterine prolapse)

It is very uncertain whether vaginal hysterectomy changes awareness of prolapse compared with sacral hysteropexy/cervicopexy (uterine prolapse) (very low certainty).

• Surgery for women with apical vaginal prolapse 2023 · Cochrane Headline outcomes only
  RR 1.01 [0.1, 9.98]
  2 studies · 200 participants
  Very low

Tranexamic acid vs placebo (saline solution or sterile water)

Tranexamic acid showed no clear difference in surgical complications compared with placebo (saline solution or sterile water) (moderate certainty).

• Tranexamic acid for the reduction of bleeding during functional endoscopic sinus surgery 2023 · Cochrane Headline outcomes only
  RD 0
  2 studies · 58 participants
  Moderate

Intervention not reported

It is very uncertain whether the intervention changes hospital or 30‐day mortality (very low certainty).

• Effects of interventions targeting the systemic inflammatory response to cardiac surgery on clinical outcomes in adults 2023 · Cochrane Headline outcomes only
  RR 0.78 [0.68, 0.91]
  190 studies · 24817 participants
  Very low

Intervention not reported

It is very uncertain whether the intervention changes myocardial injury (hospital stay) (very low certainty).

• Effects of interventions targeting the systemic inflammatory response to cardiac surgery on clinical outcomes in adults 2023 · Cochrane Headline outcomes only
  RR 1.04 [0.95, 1.14]
  86 studies · 23118 participants
  Very low

Intervention not reported

The intervention showed no clear difference in kidney injury (safety outcome) (hospital stay) (low certainty).

• Effects of interventions targeting the systemic inflammatory response to cardiac surgery on clinical outcomes in adults 2023 · Cochrane Headline outcomes only
  RR 1.06 [0.96, 1.16]
  79 studies · 23103 participants
  Low

Intervention not reported

The intervention showed no clear difference in surgical Site Infection (hospital stay) (low certainty).

• Effects of interventions targeting the systemic inflammatory response to cardiac surgery on clinical outcomes in adults 2023 · Cochrane Headline outcomes only
  RR 0.92 [0.83, 1.01]
  40 studies · 19368 participants
  Low