The Treatment of Post-hysterectomy Vaginal Vault Prolapse: A Systematic Review and Meta-analysis

Autor: Bich Ngoc Bui, Marlies Y. Bongers, Jan-Paul Roovers, Viviane Dietz, Aafke P.A. van Montfoort, Rui Wang, Anne Lotte W.M. Coolen, Ben W.J. Mol
Přispěvatelé: Amsterdam Reproduction & Development (AR&D), Obstetrics and Gynaecology, APH - Aging & Later Life
Jazyk: angličtina
Rok vydání: 2018
Předmět:
MESH
Sacrum
medicine.medical_specialty
PELVIC-ORGAN PROLAPSE
Vaginal vault prolapse
Urology
Review Article
Hysterectomy
Pelvic Organ Prolapse
law.invention
03 medical and health sciences
0302 clinical medicine
Gynecologic Surgical Procedures
Postoperative Complications
Sacrospinous fixation
Randomized controlled trial
law
MANAGEMENT
medicine
Humans
Laparoscopic sacrocolpopexy
030212 general & internal medicine
REPAIR
Sacrocolpopexy
Pelvic organ
Surgical treatment
030219 obstetrics & reproductive medicine
business.industry
Standard treatment
Obstetrics and Gynecology
General Medicine
Post-hysterectomy vaginal vault prolapse
Surgical Mesh
ABDOMINAL SACROCOLPOPEXY
SACRAL COLPOPEXY
Vaginal mesh
FASCIA LATA
Surgery
Treatment
Treatment Outcome
Satisfaction rate
Meta-analysis
Vagina
Trans vaginal mesh
RANDOMIZED-CONTROLLED-TRIAL
Female
Laparoscopy
business
Vaginal Vault Prolapse
Zdroj: International Urogynecology Journal
Obstetrical & gynecological survey, 73(3), 146-147. Lippincott Williams and Wilkins
ISSN: 0029-7828
DOI: 10.1097/ogx.0000000000000530
Popis: Introduction and hypothesis The treatment of post-hysterectomy vaginal vault prolapse (VVP) has been investigated in several randomized clinical trials (RCTs), but a systematic review of the topic is still lacking. The aim of this study is to compare the effectiveness of treatments for VVP. Methods We performed a systematic review and meta-analysis of the literature on the treatment of VVP found in PubMed and Embase. Reference lists of identified relevant articles were checked for additional articles. A network plot was constructed to illustrate the geometry of the network of the treatments included. Only RCTs reporting on the treatment of VVP were eligible, conditional on a minimum of 30 participants with VVP and a follow-up of at least 6 months. Results Nine RCTs reporting 846 women (ranging from 95 to 168 women) met the inclusion criteria. All surgical techniques were associated with good subjective results, and without differences between the compared technique, with the exception of the comparison of vaginal mesh (VM) vs laparoscopic sacrocolpopexy (LSC). LSC is associated with a higher satisfaction rate. The anatomical results of the sacrocolpopexy (laparoscopic, robotic [RSC]. and abdominal [ASC]) are the best (62–91%), followed by the VM. However, the ranges of the anatomical outcome of VM were wide (43–97%). The poorest results are described for the sacrospinal fixation (SSF; 35–81%), which also correlates with the higher reoperation rate for pelvic organ prolapse (POP; 5–9%). The highest percentage of complications were reported after ASC (2–19%), VM (6–29%), and RSC (54%). Mesh exposure was seen most often after VM (8–21%). The rate of reoperations carried out because of complications, recurrence prolapse, and incontinence of VM was 13–22%. Overall, sacrocolpopexy reported the best results at follow-up, with an outlier of one trial reporting the highest reoperation rate for POP (11%). The results of the RSC are too small to make any conclusion, but LSC seems to be preferable to ASC. Conclusions A comparison of techniques was difficult because of heterogeneity; therefore, a network meta-analysis was not possible. All techniques have proved to be effective. The reported differences between the techniques were negligible. Therefore, a standard treatment for VVP could not be given according to this review. Electronic supplementary material The online version of this article (10.1007/s00192-017-3493-2) contains supplementary material, which is available to authorized users
Databáze: OpenAIRE
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