Cochrane · systematic review · CD012079
Transvaginal mesh or grafts or native tissue repair for vaginal prolapse
Yeung, E, Baessler, K, Christmann-Schmid, C, et al. · Cochrane Database of Systematic Reviews · 2024 · Cochrane Library
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
15
current version
GRADE rated
15
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 4 · 26.7%Low 4 · 26.7%Moderate 7 · 46.7%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Current version onlyTransvaginal permanent mesh compared to native tissue repair for vaginal prolapse
Population: vaginal prolapse
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Awareness of prolapse (0.5 to 7 years) Transvaginal permanent mesh vs native tissue repair | RR 0.83 [0.73, 0.95] | 17 studies · 2932 participants | Moderate Downgraded: risk of bias |
Repeat surgery (0.5 to 7 years) Transvaginal permanent mesh vs native tissue repair | RR 1.56 [1.07, 2.26] | 27 studies · 3916 participants | Low Downgraded: risk of bias, inconsistency |
Recurrent prolapse on examination (any compartment) Transvaginal permanent mesh vs native tissue repair | RR 0.42 [0.32, 0.55] | 25 studies · 3680 participants | Very low Downgraded: risk of bias, inconsistency |
Visceral injury Transvaginal permanent mesh vs native tissue repair | RR 3.67 [1.63, 8.28] | 14 studies · 1997 participants | Low Downgraded: risk of bias, imprecision |
Mesh exposure Transvaginal permanent mesh vs native tissue repair | RR 11.1 [6.81, 18.1] | 26 studies · 2980 participants | Moderate Downgraded: risk of bias |
Bladder function Transvaginal permanent mesh vs native tissue repair | RR 1.5 [1.19, 1.88] | 17 studies · 2001 participants | Moderate Downgraded: risk of bias |
Painful intercourse ‐ de novo dyspareunia Transvaginal permanent mesh vs native tissue repair | RR 1.22 [0.83, 1.79] | 16 studies · 1308 participants | Moderate Downgraded: risk of bias |
Quality of life Transvaginal permanent mesh vs native tissue repair | no estimate extracted | 9 studies · 1365 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Transvaginal biological graft compared to native tissue repair for vaginal prolapse
Population: vaginal prolapse
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Awareness of prolapse (1 to 3 years) Transvaginal biological graft vs native tissue repair | RR 1.06 [0.73, 1.56] | 8 studies · 1374 participants | Moderate Downgraded: risk of bias |
Surgery for recurrent prolapse (1 to 2 years) Transvaginal biological graft vs native tissue repair | RR 1.15 [0.75, 1.77] | 6 studies · 899 participants | Moderate Downgraded: risk of bias |
Recurrent prolapse on examination Transvaginal biological graft vs native tissue repair | RR 0.96 [0.71, 1.29] | 9 studies · 1278 participants | Low Downgraded: risk of bias, inconsistency |
Visceral injury Transvaginal biological graft vs native tissue repair | RR 0.34 [0.04, 3.26] | 2 studies · 254 participants | Low Downgraded: risk of bias, imprecision |
Bladder function Transvaginal biological graft vs native tissue repair | RR 12.64 [1.6, 100.06] | 2 studies · 143 participants | Very low Downgraded: risk of bias, imprecision |
Painful intercourse ‐ de novo dyspareunia Transvaginal biological graft vs native tissue repair | RR 1.3 [0.46, 3.66] | 2 studies · 125 participants | Moderate Downgraded: risk of bias |
Quality of life Transvaginal biological graft vs native tissue repair | no estimate extracted | 3 studies · 112 participants | Very low Downgraded: risk of bias, imprecision |
Any transvaginal permanent mesh versus native tissue repair for vaginal prolapse
Population: women with vaginal prolapse
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Awareness of prolapse review 1 to 3 years Any transvaginal permanent mesh vs native tissue repair | RR 0.66 [0.54, 0.81] | 12 studies · 1614 participants | Moderate Downgraded: risk of bias |
Repeat surgery ‐ prolapse review 1 to 3 years Any transvaginal permanent mesh vs native tissue repair | RR 0.53 [0.31, 0.88] | 12 studies · 1675 participants | Moderate Downgraded: risk of bias |
Repeat surgery ‐ continence surgery Any transvaginal permanent mesh vs native tissue repair | RR 1.07 [0.62, 1.83] | 9 studies · 1284 participants | Low Downgraded: risk of bias |
Repeat surgery ‐ surgery for prolapse, SUI, or mesh exposure review 1 to 3 years Any transvaginal permanent mesh vs native tissue repair | RR 2.4 [1.51, 3.81] | 7 studies · 867 participants | Moderate Downgraded: risk of bias |
Recurrent prolapse review 1 to 3 years Any transvaginal permanent mesh vs native tissue repair | RR 0.4 [0.3, 0.53] | 21 studies · 2494 participants | Low Downgraded: risk of bias |
Bladder injury Any transvaginal permanent mesh vs native tissue repair | RR 3.92 [1.62, 9.5] | 11 studies · 1514 participants | Moderate Downgraded: risk of bias |
De novo dyspareunia (pain during sexual intercourse) review 1 to 3 years Any transvaginal permanent mesh vs native tissue repair | RR 0.92 [0.58, 1.47] | 11 studies · 764 participants | Low Downgraded: risk of bias |
De novo stress urinary incontinence review 1 to 3 years Any transvaginal permanent mesh vs native tissue repair | RR 1.39 [1.06, 1.82] | 12 studies · 1512 participants | Low Downgraded: risk of bias |
Quality of life review 1 to 2 years Any transvaginal permanent mesh vs native tissue repair | no estimate extracted | 7 studies · 665 participants | Very low Downgraded: risk of bias |
Absorbable mesh versus native tissue repair for vaginal prolapse
Population: women with vaginal prolapse
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Awareness of prolapse at 2 years Absorbable mesh vs native tissue repair | RR 1.05 [0.77, 1.44] | 1 study · 54 participants | Very low Downgraded: risk of bias, imprecision |
Repeat surgery for prolapse (stage 2 or more) at 2 years Absorbable mesh vs native tissue repair | RR 0.47 [0.09, 2.4] | 1 study · 66 participants | Very low Downgraded: risk of bias, imprecision |
Recurrent prolapse at 3 months to 2 years Absorbable mesh vs native tissue repair | RR 0.71 [0.52, 0.96] | 3 studies · 292 participants | Low Downgraded: risk of bias, imprecision |
Bladder injury Absorbable mesh vs native tissue repair | no estimate extracted | NR | No studies |
De novo dyspareunia (pain during sexual intercourse) review 1 to 3 years Absorbable mesh vs native tissue repair | no estimate extracted | NR | No studies |
Stress urinary incontinence at 2 years Absorbable mesh vs native tissue repair | RR 1.38 [0.95, 2] | 1 study · 49 participants | Very low Downgraded: risk of bias, imprecision |
Quality of life at 2 years Absorbable mesh vs native tissue repair | mean difference 0 | 1 study · 54 participants | Very low Downgraded: risk of bias, imprecision |
Biological repair versus native tissue repair for vaginal prolapse
Population: women with vaginal prolapse
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Awareness of prolapse at 1 to 3 years Biological repair vs native tissue repair | RR 0.97 [0.65, 1.43] | 7 studies · 777 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Repeat prolapse surgery 1 to 2 years Biological repair vs native tissue repair | RR 1.22 [0.61, 2.44] | 5 studies · 306 participants | Low Downgraded: risk of bias, imprecision |
Recurrent prolapse at 1 year Biological repair vs native tissue repair | RR 0.94 [0.6, 1.47] | 7 studies · 587 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Bladder injury Biological repair vs native tissue repair | no estimate extracted | 1 study · 137 participants | Ungraded |
Bowel injury Biological repair vs native tissue repair | no estimate extracted | 1 study · 137 participants | Ungraded |
De novo dyspareunia (pain during sexual intercourse) review 1 to 3 years Biological repair vs native tissue repair | RR 0.85 [0.2, 3.67] | 1 study · 37 participants | Very low Downgraded: imprecision |
De novo urinary stress incontinence at 1 year Biological repair vs native tissue repair | no estimate extracted | 1 study · 56 participants | Ungraded |
Quality of life at 1 year Biological repair vs native tissue repair | no estimate extracted | 2 studies · 84 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |