Sacrocolpopexy Using Polyvinylidene Fluoride Mesh: A Systematic Review and Meta-Analysis

This review aimed to assess the clinical outcomes and complications of polyvinylidene fluoride (PVDF) mesh in sacrocolpopexy (SCP).

A systematic search was conducted on Google Scholar, PubMed, Web of Science, Scopus, and Embase up to October 2024. All study designs employing PVDF mesh in SCP were included. Demographic features, mesh types, surgical method, surgical outcomes, and mesh exposure, among other outcomes and complications, were extracted by two independent researchers. The registered protocol is available online on PROSPERO (ID: CRD42023405734).

Out of 319 studies screened, 12 were finally included in the systematic review and meta-analysis, encompassing 1093 female patients who underwent SCP. Four studies employed polypropylene (PP) as the comparator. Abdominal sacrocolpopexy (ASC) was used by six studies, five adhered to the laparoscopic method and one used both. Meta-analysis indicated pooled prevalence rates close to 0% for mesh exposure, recurrence, sexual dysfunction (SD), and reoperation in the PVDF group; however, small sample sizes and wide confidence intervals diminish the definitive conclusion. The prevalence of urge urinary incontinence (UUI) was 33%, while both stress urinary incontinence (SUI) and de novo incontinence had a prevalence of 6%. However, the differences between PVDF and PP outcomes and complications were not statistically significant.

No significant differences were found between PVDF mesh and PP. Our findings highlight the need for further robust evidence to indicate the possible differences between PVDF and conventional materials, especially PP.