Mesh Surgery for Anterior Vaginal Wall Prolapse: A Meta-analysis

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dc.contributor.author Teatin Juliato, Cassia Raquel
dc.contributor.author do Santos Junior, Luiz Carlos
dc.contributor.author Haddad, Jorge Milhem
dc.contributor.author Castro, Rodrigo Aquino [UNIFESP]
dc.contributor.author Lima, Marcelo
dc.contributor.author de Castro, Edilson Benedito
dc.date.accessioned 2020-08-14T13:44:31Z
dc.date.available 2020-08-14T13:44:31Z
dc.date.issued 2016
dc.identifier http://dx.doi.org/10.1055/s-0036-1585074
dc.identifier.citation Revista Brasileira De Ginecologia E Obstetricia. Rio De Janeiro Rj, v. 38, n. 7, p. 356-364, 2016.
dc.identifier.issn 0100-7203
dc.identifier.uri https://repositorio.unifesp.br/handle/11600/57713
dc.description.abstract Purpose Pelvic organ prolapse (POP) is a major health issue worldwide, affecting 6-8% of women. The most affected site is the anterior vaginal wall. Multiple procedures and surgical techniques have been used, with or without the use of vaginalmeshes, due to common treatment failure, reoperations, and complication rates in some studies. Methods Systematic review of the literature and meta-analysis regarding the use of vaginal mesh in anterior vaginal wall prolapse was performed. A total of 115 papers were retrieved after using the medical subject headings (MESH) terms: 'anterior pelvic organ prolapse OR cystocele AND surgery AND (mesh or colporrhaphy)' in the PubMed database. Exclusion criteria were: follow-up shorter than 1 year, use of biological or absorbable meshes, and inclusion of other vaginal wall prolapses. Studies were put in a data chart by two independent editors en
dc.description.abstract results found in at least two studies were grouped for analysis. Results After the review of the titles by two independent editors, 70 studies were discarded, and after abstract assessment, 18 trials were eligible for full text screening. For final screening and meta-analysis, after applying the Jadad score (> 2), 12 studies were included. Objective cure was greater in the mesh surgery group (odds ratio [OR] = 1,28 [1,07-1,53]), which also had greater blood loss (mean deviation [MD] = 45,98 [9,72-82,25]), longer surgery time (MD = 15,08 [0,48-29,67]), but less prolapse recurrence (OR = 0,22 [01,3-0,38]). Dyspareunia, symptom resolution and reoperation rates were not statistically different between groups. Quality of life (QOL) assessment through the pelvic organ prolapse/urinary incontinence sexual questionnaire (PISQ-12), the pelvic floor distress inventory (PFDI-20), the pelvic floor impact questionnaire (PFIQ-7), and the perceived quality of life scale (PQOL) was not significantly different. Conclusions Anterior vaginal prolapse mesh surgery has greater anatomic cure rates and less recurrence, although there were no differences regarding subjective cure, reoperation rates and quality of life. Furthermore, mesh surgery was associated with longer surgical time and greater blood loss. Mesh use should be individualized, considering prior history and risk factors for recurrence. en
dc.format.extent 356-364
dc.language.iso por
dc.publisher Federacao Brasileira Soc Ginecologia & Obstetricia-Febrasgo
dc.relation.ispartof Revista Brasileira De Ginecologia E Obstetricia
dc.rights Acesso aberto
dc.subject anterior pelvic organ prolapse en
dc.subject cystocele en
dc.subject surgery en
dc.subject mesh en
dc.subject colporrhaphy en
dc.subject meta-analysis en
dc.title Mesh Surgery for Anterior Vaginal Wall Prolapse: A Meta-analysis en
dc.type Artigo
dc.description.affiliation Univ Estadual Campinas, Dept Obstet & Gynecol, Rua Alexander Fleming 101, BR-13083881 Campinas, SP, Brazil
dc.description.affiliation Univ Sao Paulo, Dept Urogynecol, Sao Paulo, Brazil
dc.description.affiliation Univ Fed Sao Paulo, Dept Obstet & Gynecol, Sao Paulo, SP, Brazil
dc.description.affiliationUnifesp Univ Fed Sao Paulo, Dept Obstet & Gynecol, Sao Paulo, SP, Brazil
dc.identifier.file WOS000410247300007.pdf
dc.identifier.scielo S0100-72032016000700356
dc.identifier.doi 10.1055/s-0036-1585074
dc.description.source Web of Science
dc.identifier.wos WOS:000410247300007
dc.coverage Rio De Janeiro Rj
dc.citation.volume 38
dc.citation.issue 7



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