Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

303 questions · 321 findings · 26 reviews · Gynaecology and Fertility · Headline outcomes only

No studies found 64 · 19.9%GRADE not reported 3 · 0.9%Very low 67 · 20.9%Low 104 · 32.4%Moderate 77 · 24%High 6 · 1.9%

Surgery vs LNG‐IUS

Satisfaction rate: surgery versus LNG‐IUS Endometrial ablation versus LNG‐IUS At 2 years · women with heavy menstrual bleeding

Surgery showed no clear difference in satisfaction rate: surgery versus LNG‐IUS Endometrial ablation… compared with LNG‐IUS (low certainty).

1 finding from 1 review

Surgery vs LNG‐IUS

Satisfaction rate: surgery versus LNG‐IUS Endometrial ablation versus LNG‐IUS At 1 year · women with heavy menstrual bleeding

Surgery showed no clear difference in satisfaction rate: surgery versus LNG‐IUS Endometrial ablation… compared with LNG‐IUS (low certainty).

1 finding from 1 review

Pelvic floor muscle training before and after prolapse surgery vs no training

Repeat surgery (or pessary) for recurrent prolapse · women undergoing pelvic organ prolapse surgery

Pelvic floor muscle training before and after prolapse surgery showed no clear difference in repeat surgery (or pessary) for recurrent prolapse compared with no training (low certainty).

1 finding from 1 review

Surgery vs oral medication

Control of bleeding (cure or improvement to acceptable level) At 2 years · women with heavy menstrual bleeding

Surgery probably leads to higher control of bleeding (cure or improvement to acceptable level) At 4… compared with oral medication (moderate certainty).

3 findings from 1 review

Surgery vs LNG‐IUS

Proportion of women with adverse events Endometrial ablation versus LNG‐IUS. At one year · women with heavy menstrual bleeding

Surgery probably leads to lower proportion of women with adverse events Endometrial ablation versus… compared with LNG‐IUS (moderate certainty).

1 finding from 1 review

Surgery vs oral medication

Overall satisfaction with treatment At 5 years · women with heavy menstrual bleeding

It is very uncertain whether surgery changes overall satisfaction with treatment At 5 years compared with oral medication (very low certainty).

1 finding from 1 review

Surgery vs LNG‐IUS

Objective control of bleeding: menstrual loss under 80 ml per cycle LNG‐IUS versus hysterectomy At 1 year · women with heavy menstrual bleeding

Surgery probably leads to higher objective control of bleeding: menstrual loss under 80 ml per cycle… compared with LNG‐IUS (moderate certainty).

1 finding from 1 review

Surgery vs LNG‐IUS

Subjective control of bleeding: PBAC no more than 75 per cycle Endometrial resection or ablation versus LNG‐IUS At 1 year · women with heavy menstrual bleeding

Surgery may leads to higher subjective control of bleeding: PBAC no more than 75 per cycle… compared with LNG‐IUS (low certainty).

1 finding from 1 review

Vaginal POP surgery with armed mesh vs anterior native tissue repair

One type of POP surgery vs another: armed anterior mesh vs anterior native tissue repair · continent women with POP

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).

1 finding from 1 review

POP surgery with concomitant continence procedure vs no concomitant continence procedure

Vaginal POP surgery with vs without MUS · women with POP and SUI

POP surgery with concomitant continence procedure probably leads to lower vaginal POP surgery with vs without MUS compared with no concomitant continence procedure (moderate certainty).

2 findings from 1 review

POP surgery with concomitant continence procedure vs no concomitant continence procedure

Vaginal POP surgery with concomitant vs delayed continence surgery: additional concomitant MUS vs delayed MUS · women with POP and SUI

POP surgery with concomitant continence procedure showed no clear difference in vaginal POP surgery with concomitant vs delayed continence surgery:… compared with no concomitant continence procedure (moderate certainty).

1 finding from 1 review

POP surgery with concomitant continence procedure vs no concomitant continence procedure

Abdominal POP surgery with or without concomitant continence surgery: additional Burch colposuspension vs sacrocolpopexy alone · women with POP and SUI

POP surgery with concomitant continence procedure showed no clear difference in abdominal POP surgery with vs without concomitant continence… compared with no concomitant continence procedure (moderate certainty).

1 finding from 1 review

Vaginal POP surgery with concomitant continence procedure vs no concomitant continence procedure

Vaginal POP surgery with or without concomitant continence surgery: additional MUS vs vaginal repair alone · women with POP and occult SUI

Vaginal POP surgery with concomitant continence procedure probably leads to lower vaginal POP surgery with or without concomitant continence surgery:… compared with no concomitant continence procedure (moderate certainty).

1 finding from 1 review

Vaginal or abdominal POP surgery with concomitant continence procedure vs no concomitant continence procedure

Vaginal POP surgery with or without concomitant continence surgery: additional MUS vs vaginal repair alone · continent women with POP

Vaginal or abdominal POP surgery with concomitant continence procedure showed no clear difference in vaginal POP surgery with or without concomitant continence surgery:… compared with no concomitant continence procedure (moderate certainty).

1 finding from 1 review

Vaginal or abdominal POP surgery with concomitant continence procedure vs no concomitant continence procedure

Abdominal POP surgery with or without concomitant continence surgery: additional Burch colposuspension vs sacrocolpopexy alone · continent women with POP

Vaginal or abdominal POP surgery with concomitant continence procedure showed no clear difference in abdominal POP surgery with or without concomitant continence… compared with no concomitant continence procedure (low certainty).

1 finding from 1 review