Related Experiment Video
Updated: Jul 21, 2025
03:30
Author Spotlight: Advancing Pelvic Prolapse Treatment with a Non-Mesh Approach using Laparoscopic Pectopexy
Published on: October 25, 2024
1.5K
Surgery for women with apical vaginal prolapse
Christopher Maher1, Ellen Yeung2, Nir Haya3
1Wesley and Royal Brisbane and Women's Hospitals, Brisbane, Australia.
The Cochrane Database of Systematic Reviews
|July 26, 2023
Summary
Sacral colpopexy shows better outcomes for apical vaginal prolapse compared to vaginal procedures, reducing prolapse recurrence and awareness. Transvaginal mesh offers no advantage over native tissue repair and has risks.
Area of Science:
- Gynecologic surgery
- Pelvic organ prolapse
- Urogynecology
Background:
- Apical vaginal prolapse involves the descent of the uterus or vaginal vault.
- Numerous surgical treatments exist, but evidence-based guidelines are lacking.
- Optimal surgical management requires comparative safety and efficacy data.
Purpose of the Study:
- To evaluate the safety and efficacy of surgical interventions for apical vaginal prolapse.
- To compare different surgical approaches and their outcomes.
Main Methods:
- Systematic review of randomized controlled trials (RCTs).
- Searched multiple databases including Cochrane, MEDLINE, and ClinicalTrials.gov.
- Primary outcomes included prolapse awareness, repeat surgery, and recurrence.
Main Results:
- Sacral colpopexy demonstrated lower rates of prolapse awareness, recurrence, and repeat surgery compared to vaginal procedures.
- Vaginal procedures were associated with higher rates of stress urinary incontinence (SUI).
- Transvaginal mesh showed no benefit over native tissue repair but had a 17.5% mesh exposure rate.
Conclusions:
- Sacral colpopexy is associated with better outcomes for apical vaginal prolapse than vaginal interventions.
- Current evidence does not support transvaginal mesh use for apical prolapse.
- Laparoscopic sacral colpopexy offers advantages in operating time and admission duration.
