The aim of the present systematic review and meta-analysis was to compare native tissue repair (NTR) against transvaginal mesh augmentation for the repair of anterior vaginal prolapse. A total of 2289 articles were found but only 27 (24.8 %) were included in the review. Guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) were followed to guide the process of the systematic review and meta- analysis. The quality of the observational studies was evaluated according to the Scottish Intercollegiate Guidelines Network, whereas the quality of randomized control trials (RCT) was assessed by the Cochrane risk- of-bias scale. The mesh repair intervention was associated with a higher anatomical cure rate in comparison with NTR repair when the follow-up was ≤24 months [pooled risk difference (95 % CI): − 0.18 % (− 0.22 %; 0.13 %); p-value: <0.0001; I2: 36.0 %]. Studies reporting anatomical failure had similar findings [pooled risk difference (95 % CI): 0.17 % (0.01 %; 0.33 %); p-value: 0.03; I2: 88.6 %]. No differences in the risk of re-operation were observed between NTR repair and mesh augmentation. Pooled risk differences in the incidence of post-surgical and late complications were higher for the mesh repair intervention [− 0.05 % (95 % CI: − 0.10 %; 0.00 %) p- value: 0.05; I2: 68.3 %] [− 0.05 % (95 % CI: − 0.14 %; 0.03 %) p-value: 0.25; I2: 82.0 %]. Women who underwent mesh repair reported greater satisfaction than women who underwent NTR [pooled risk difference (95 % CI): − 0.07 % (− 0.16 %; 0.02 %); p-value: 0.15; I2: 65.3 %]. In conclusion, mesh repair surgery had higher anatomical cure and satisfaction rates, with no differences in re-operation rate, but had higher post-surgical and late complications in comparison with NTR.

Native tissue repair (NTR) versus transvaginal mesh interventions for the treatment of anterior vaginal prolapse: Systematic review and meta-analysis / Capobianco, Giampiero; Sechi, Illari; Muresu, Narcisa; Saderi, Laura; Piana, Andrea Fausto; Farina, Mario; Dessole, Francesco; Virdis, Giuseppe; De Vita, Davide; Madonia, Massimo; Petrillo, Marco; Sotgiu, Giovanni. - In: MATURITAS. - ISSN 0378-5122. - 165:(2022), pp. 104-112. [10.1016/j.maturitas.2022.07.013]

Native tissue repair (NTR) versus transvaginal mesh interventions for the treatment of anterior vaginal prolapse: Systematic review and meta-analysis

Giampiero Capobianco
Writing – Review & Editing
;
Illari Sechi
Formal Analysis
;
Narcisa Muresu
Formal Analysis
;
Laura Saderi
Writing – Original Draft Preparation
;
Andrea Piana
Visualization
;
Mario Farina
Data Curation
;
Francesco Dessole
Investigation
;
Giuseppe Virdis
Formal Analysis
;
Massimo Madonia;Marco Petrillo
Writing – Review & Editing
;
Giovanni Sotgiu.
Writing – Original Draft Preparation
2022

Abstract

The aim of the present systematic review and meta-analysis was to compare native tissue repair (NTR) against transvaginal mesh augmentation for the repair of anterior vaginal prolapse. A total of 2289 articles were found but only 27 (24.8 %) were included in the review. Guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) were followed to guide the process of the systematic review and meta- analysis. The quality of the observational studies was evaluated according to the Scottish Intercollegiate Guidelines Network, whereas the quality of randomized control trials (RCT) was assessed by the Cochrane risk- of-bias scale. The mesh repair intervention was associated with a higher anatomical cure rate in comparison with NTR repair when the follow-up was ≤24 months [pooled risk difference (95 % CI): − 0.18 % (− 0.22 %; 0.13 %); p-value: <0.0001; I2: 36.0 %]. Studies reporting anatomical failure had similar findings [pooled risk difference (95 % CI): 0.17 % (0.01 %; 0.33 %); p-value: 0.03; I2: 88.6 %]. No differences in the risk of re-operation were observed between NTR repair and mesh augmentation. Pooled risk differences in the incidence of post-surgical and late complications were higher for the mesh repair intervention [− 0.05 % (95 % CI: − 0.10 %; 0.00 %) p- value: 0.05; I2: 68.3 %] [− 0.05 % (95 % CI: − 0.14 %; 0.03 %) p-value: 0.25; I2: 82.0 %]. Women who underwent mesh repair reported greater satisfaction than women who underwent NTR [pooled risk difference (95 % CI): − 0.07 % (− 0.16 %; 0.02 %); p-value: 0.15; I2: 65.3 %]. In conclusion, mesh repair surgery had higher anatomical cure and satisfaction rates, with no differences in re-operation rate, but had higher post-surgical and late complications in comparison with NTR.
Native tissue repair (NTR) versus transvaginal mesh interventions for the treatment of anterior vaginal prolapse: Systematic review and meta-analysis / Capobianco, Giampiero; Sechi, Illari; Muresu, Narcisa; Saderi, Laura; Piana, Andrea Fausto; Farina, Mario; Dessole, Francesco; Virdis, Giuseppe; De Vita, Davide; Madonia, Massimo; Petrillo, Marco; Sotgiu, Giovanni. - In: MATURITAS. - ISSN 0378-5122. - 165:(2022), pp. 104-112. [10.1016/j.maturitas.2022.07.013]
File in questo prodotto:
Non ci sono file associati a questo prodotto.

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11388/295303
Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus ND
  • ???jsp.display-item.citation.isi??? ND
social impact