Cochrane · systematic review · CD012975
Surgery for women with posterior compartment prolapse
Mowat, A, Maher, D, Baessler, K, et al. · Cochrane Database of Systematic Reviews · 2018 · Cochrane Library
Gynaecology and FertilityAMSTAR 2: not assessed
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
16
current version
GRADE rated
14
No studies
2
Included studies
NR
No studies 2 · 12.5%Ungraded 0 · 0%Very low 1 · 6.3%Low 9 · 56.3%Moderate 4 · 25%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
Transanal repair versus transvaginal repair
Population: women with posterior vaginal wall prolapse
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Outcomes ( Transanal repair vs transvaginal repair | no estimate extracted | NR | No studies |
Awareness of prolapse (subjective failure) (12‐25 months) Transanal repair vs transvaginal repair | RR 2.78 [1, 7.7] | 2 studies · 87 participants | Low Downgraded: risk of bias, imprecision |
Repeat surgery for any prolapse (25 months) Transanal repair vs transvaginal repair | RR 2.42 [0.75, 7.88] | 1 study · 57 participants | Low Downgraded: risk of bias, imprecision |
Recurrent posterior vaginal wall prolapse (objective failure) (12‐25 months) Transanal repair vs transvaginal repair | RR 4.12 [1.56, 10.88] | 2 studies · 87 participants | Moderate Downgraded: risk of bias, imprecision |
Postoperative obstructed defecation (6‐25 months) Transanal repair vs transvaginal repair | RR 1.67 [1, 2.79] | 3 studies · 113 participants | Low Downgraded: risk of bias, imprecision |
Postoperative dyspareunia (12‐25 months) Transanal repair vs transvaginal repair | RR 0.32 [0.09, 1.15] | 2 studies · 80 participants | Low Downgraded: risk of bias, imprecision |
Postoperative complications (6‐25 months) Transanal repair vs transvaginal repair | RR 3.57 [0.94, 13.54] | 3 studies · 135 participants | Low Downgraded: risk of bias, imprecision |
Operating time (12‐50 months) Transanal repair vs transvaginal repair | no estimate extracted | 3 studies · 137 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Biological graft versus native tissue repair for posterior vaginal wall prolapse
Population: women with posterior vaginal wall prolapse
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Outcomes ( Biological graft vs native tissue repair | no estimate extracted | NR | No studies |
Awareness of prolapse (subjective failure) (16‐24 months) Biological graft vs native tissue repair | RR 1.09 [0.45, 2.62] | 2 studies · 181 participants | Moderate Downgraded: imprecision |
Repeat surgery for any prolapse (24 months) Biological graft vs native tissue repair | RR 0.6 [0.18, 1.97] | 2 studies · 271 participants | Low Downgraded: imprecision |
Recurrent posterior vaginal wall prolapse (objective failure) (16‐24 months) Biological graft vs native tissue repair | RR 0.55 [0.3, 1.01] | 3 studies · 377 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Postoperative obstructed defecation (16‐24 months) Biological graft vs native tissue repair | RR 0.96 [0.5, 1.86] | 2 studies · 172 participants | Moderate Downgraded: imprecision |
Postoperative dyspareunia (16‐24 months) Biological graft vs native tissue repair | RR 1.26 [0.59, 2.68] | 2 studies · 152 participants | Low Downgraded: imprecision |
Postoperative complications (including wound infection) (16‐24 months) Biological graft vs native tissue repair | RR 1.82 [1.22, 2.72] | 3 studies · 448 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Operating time (24 months) Biological graft vs native tissue repair | no estimate extracted | 1 study · 68 participants | Low Downgraded: risk of bias, imprecision, inconsistency |