Systematic review of the efficacy and safety of using mesh or grafts in surgery for anterior and/or posterior vaginal wall prolapse

Summary

This systematic review was conducted as part of the HSRU Review Body for Interventional Procedures (ReBIP) project supported by the National Institute for Health and Clinical Excellence (NICE) Interventional Procedures Programme. 

The evidence suggested that surgical repair of vaginal wall prolapse using mesh may be more efficacious than traditional surgical repair of vaginal wall prolapse without mesh. Both efficacy and safety varied with different types of mesh, and the data on efficacy in the long term were limited in quantity.  There was a risk of complications that can cause significant morbidity.

As a result of the review, Interventional procedure guidance no. 267 was issued.  The Interventional Procedures Committee recommended that this procedure should only be used with special arrangements for clinical governance, consent and audit or research.  Partly in response, the HSRU / CHaRT trial PROSPECT was funded to provide this evidence.  

Contact

Cathryn Glazener; c.glazener@abdn.ac.uk (member of review team)

Status

Complete

Publications

Jia X, Glazener CM, Mowatt G, MacLennan GS, Fraser C, Bain C, Burr JM. Efficacy and safety of using mesh or grafts in surgery for anterior and/or posterior vaginal wall prolapse: systematic review and meta-analysis. Br J Obstet Gynaecol 2008;115(11):1350-61.