Document Detail

Complication and reoperation rates after apical vaginal prolapse surgical repair: a systematic review.
MedLine Citation:
PMID:  19155908     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To compare postoperative complication and reoperation rates for surgical procedures correcting apical vaginal prolapse. DATA SOURCES: Eligible studies were selected through an electronic literature search covering January 1985 to January 2008 using PubMed, the Cochrane Central Register of Controlled Trials, the Cochrane Database of Systematic Reviews, and the Database of Abstracts of Reviews and Effects. METHODS OF STUDY SELECTION: Only clinical trials and observational studies addressing apical prolapse repair and recurrence or complication rates were included. The search was restricted to original articles published in English with 50 or more participants and a follow-up period of 3 months or longer. Oral platform and poster presentations from the American Urogynecological Society, the Society for Gynecologic Surgeons, the International Urogynecological Association, and the International Continence Society from January 2005 to December 2007 were hand searched to determine whether they were eligible for inclusion. TABULATION, INTEGRATION, AND RESULTS: Procedures were separated into three groups: traditional vaginal surgery, sacral colpopexy, and vaginal mesh kits. Complications were classified using the Dindo grading system. Weighted averages were calculated for each Dindo grade, complication, and reoperation. Dindo grade IIIa (433/3,425 women) and IIIb (245/3,425) rates were highest in the mesh kit group owing to higher rates of mesh erosion (198/3,425) and fistulae (8/3,425). Reoperation rates for prolapse recurrence were highest in the traditional vaginal surgery group (308/7,827). The total reoperation rate was greatest in the mesh kit group (291/3, 425, 8.5%). CONCLUSION: The rate of complications requiring reoperation and the total reoperation rate was highest for vaginal mesh kits despite a lower reoperation rate for prolapse recurrence and shorter overall follow-up.
Gouri B Diwadkar; Matthew D Barber; Benjamin Feiner; Christopher Maher; J Eric Jelovsek
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Publication Detail:
Type:  Journal Article; Meta-Analysis; Review    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  113     ISSN:  0029-7844     ISO Abbreviation:  Obstet Gynecol     Publication Date:  2009 Feb 
Date Detail:
Created Date:  2009-01-21     Completed Date:  2009-02-23     Revised Date:  2009-10-26    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  367-73     Citation Subset:  AIM; IM    
Department of OB/GYN, Cleveland Clinic, Cleveland, OH 44198, USA.
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MeSH Terms
Gynecologic Surgical Procedures / adverse effects*
Postoperative Complications / epidemiology*
Reoperation / statistics & numerical data
Suburethral Slings / adverse effects*
Urologic Surgical Procedures / adverse effects*
Uterine Prolapse / surgery*
Erratum In:
Obstet Gynecol. 2009 Jun;113(6):1377

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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