Systematic review of the efficacy and safety of using mesh in surgery for uterine or vaginal vault prolapse

INTRODUCTION AND HYPOTHESIS The aim of this study is to estimate efficacy and safety of mesh in surgery for uterine or vault prolapse. METHODS Seventeen electronic databases were searched for relevant studies that were published from 1980 onwards. RESULTS Fifty-four studies involving 7,054 women were included. For sacrocolpopexy (average follow-up 23 months), the risk of clinical recurrence ranged from 0% to 6%, persistent symptoms ranged from 3% to 31% and mesh erosion from 0% to 12%. For infracoccygeal sacropexy (average follow-up 13 months), the risk of clinical recurrence ranged from 0% to 25%, persistent symptoms from 2% to 21% and mesh erosion 0% to 21%. Limited evidence was available for sacrocolpoperineopexy and uterine suspension sling to draw reliable estimates. CONCLUSIONS Sacrocolpopexy was associated with a low risk of recurrence but with a relatively high risk of mesh erosion. Ranges of estimates for outcomes for other mesh techniques were wide.