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 abdominal hysterectomy

• Surgical approach to hysterectomy for benign gynaecological disease 2023 · Cochrane Headline outcomes only
  no estimate extracted
  4 studies · 274 participants
  Moderate

Vaginal hysterectomy vs abdominal hysterectomy

It is very uncertain whether vaginal hysterectomy changes long‐term outcomes compared with abdominal hysterectomy (very low certainty).

• Surgical approach to hysterectomy for benign gynaecological disease 2023 · Cochrane Headline outcomes only
  OR 2.69 [0.5, 14.42]
  1 study · 119 participants
  Very low

Vaginal hysterectomy vs abdominal hysterectomy

Vaginal hysterectomy showed no clear difference in long‐term complications (dichotomous) compared with abdominal hysterectomy (low certainty).

• Surgical approach to hysterectomy for benign gynaecological disease 2023 · Cochrane Headline outcomes only
  OR 3.2 [0.32, 31.9]
  2 studies · 177 participants
  Low

Vaginal hysterectomy vs abdominal hysterectomy

Vaginal hysterectomy showed no clear difference in intra‐operative visceral injury (dichotomous) compared with abdominal hysterectomy (low certainty).

• Surgical approach to hysterectomy for benign gynaecological disease 2023 · Cochrane Headline outcomes only
  OR 1.62 [0.52, 4.99]
  7 studies · 697 participants
  Low

Vaginal hysterectomy vs abdominal hysterectomy

Vaginal hysterectomy showed no clear difference in major short‐term complications (dichotomous) compared with abdominal hysterectomy (low certainty).

• Surgical approach to hysterectomy for benign gynaecological disease 2023 · Cochrane Headline outcomes only
  OR 3.14 [0.48, 20.55]
  3 studies · 216 participants
  Low

Vaginal hysterectomy vs vaginal hysteropexy (uterine prolapse)

Vaginal hysterectomy showed no clear difference in awareness of prolapse compared with vaginal hysteropexy (uterine prolapse) (moderate certainty).

• Surgery for women with apical vaginal prolapse 2023 · Cochrane Headline outcomes only
  RR 1 [0.44, 2.24]
  2 studies · 365 participants
  Moderate

Vaginal hysterectomy vs vaginal hysteropexy (uterine prolapse)

Vaginal hysterectomy showed no clear difference in surgery for recurrent prolapse compared with vaginal hysteropexy (uterine prolapse) (moderate certainty).

• Surgery for women with apical vaginal prolapse 2023 · Cochrane Headline outcomes only
  RR 1.32 [0.67, 2.6]
  3 studies · 443 participants
  Moderate

Vaginal hysterectomy vs vaginal hysteropexy (uterine prolapse)

Vaginal hysterectomy showed no clear difference in prolapse on examination (Stage 2 or above) ‐ Any recurrent prolapse compared with vaginal hysteropexy (uterine prolapse) (low certainty).

• Surgery for women with apical vaginal prolapse 2023 · Cochrane Headline outcomes only
  RR 1.44 [0.79, 2.61]
  2 studies · 361 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 hysterectomy vs sacral hysteropexy/cervicopexy (uterine prolapse)

Vaginal hysterectomy showed no clear difference in surgery for recurrent prolapse compared with sacral hysteropexy/cervicopexy (uterine prolapse) (low certainty).

• Surgery for women with apical vaginal prolapse 2023 · Cochrane Headline outcomes only
  RR 0.85 [0.47, 1.54]
  5 studies · 403 participants
  Low

Vaginal hysterectomy vs sacral hysteropexy/cervicopexy (uterine prolapse)

Vaginal hysterectomy showed no clear difference in prolapse on examination (Stage 2 or greater) ‐ Any recurrent prolapse compared with sacral hysteropexy/cervicopexy (uterine prolapse) (moderate certainty).

• Surgery for women with apical vaginal prolapse 2023 · Cochrane Headline outcomes only
  RR 0.78 [0.54, 1.11]
  2 studies · 230 participants
  Moderate

Vaginal hysterectomy vs sacral hysteropexy/cervicopexy (uterine prolapse)

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

• Surgery for women with apical vaginal prolapse 2023 · Cochrane Headline outcomes only
  RR 1.85 [0.7, 4.87]
  4 studies · 307 participants
  Very low

Vaginal hysterectomy vs sacral hysteropexy/cervicopexy (uterine prolapse)

• Surgery for women with apical vaginal prolapse 2023 · Cochrane Headline outcomes only
  no estimate extracted
  5 studies · 422 participants
  Low

Vaginal hysterectomy vs sacral hysteropexy/cervicopexy (uterine prolapse)

• Surgery for women with apical vaginal prolapse 2023 · Cochrane Headline outcomes only
  no estimate extracted
  5 studies · 422 participants
  Very low

Vaginal hysterectomy vs sacral hysteropexy/cervicopexy (uterine prolapse)

• Surgery for women with apical vaginal prolapse 2023 · Cochrane Headline outcomes only
  no estimate extracted
  2 studies · 148 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

Laparoscopic hysterectomy vs vaginal hysterectomy

• Surgical approach to hysterectomy for benign gynaecological disease 2023 · Cochrane Headline outcomes only
  no estimate extracted
  3 studies · 238 participants
  Low