[Is the use of synthetic mesh by vaginal route decrease the risk of cystocele recurrence? Clinical practice...

Area of Science:

• Urology
• Gynecology
• Surgical Innovation

Background:

• Vaginal surgery for cystocele aims to prevent prolapse recurrence.
• Complications like mesh erosion have prompted comparative studies.

Purpose of the Study:

• To systematically review evidence comparing vaginal surgery with and without mesh for cystocele repair.
• To evaluate anatomical and functional outcomes, and complication rates.

Main Methods:

• Systematic literature review of meta-analyses, randomized trials, and observational studies.
• Searches included PubMed, Medline, Cochrane Library, and EMBASE.
• Methodology followed HAS clinical practice guidelines.

Main Results:

• Synthetic mesh significantly improves anatomical results compared to autologous surgery (NP1).
• No significant difference in functional outcomes was observed.
• Mesh use is associated with increased reoperations due to complications, including vaginal erosions.

Conclusions:

• While mesh enhances anatomical repair for cystocele, its lack of functional improvement and increased reoperation risk due to complications do not support routine use.
• Mesh use for primary cystocele should be decided case-by-case, considering uncertain long-term risk-benefit (Grade B).
• Further research is needed for specific high-risk populations.