Abstract
Background
Several authors have recently compared the outcomes and complications of surgical
procedures that preserve or remove the uterus in the treatment of pelvic organ prolapse
(POP) and stress urinary incontinence (SUI). Following the publication of several
high quality randomized control trials on this topic we performed a new systematic
review and meta analysis of this data.
Methods
We performed a systematic literature search in ClinicalTrials.gov, PubMed, Scopus,
Ovid, EBSCO host, Science Direct, Web of Science, and Cochrane CENTRAL for randomized
controlled and cohort trials of uterine sparing prolapse repair (hysteropexy) versus
hysterectomy with suspension. A total of 1285 patients from 14 studies were included
in our systematic review and meta-analysis.
Results
Uterine sparing procedures (hysteropexy) were comparable to hysterectomy with suspension
for recurrence rates (RR = 0.908, 95% CI [0.385, 2.143]), reoperation rates (RR = 1.517,
95% CI [0.802, 2.868]), length of hospital stay, (SMD = − 0.159 days, 95% CI [−0.375,
0.057]), voiding dysfunction (RR = 1.089, 95% CI [0.695, 1.706]), and intraoperative
blood loss (SMD = − 0.339, 95% CI [−0.631, 0.047]). However, hysteropexy had shorter
operative time than hysterectomy with suspension (SMD = − 1.191 h, 95% CI [−1.836,
−0.545]), and fewer visceral injuries (RR = 0.421, 95% CI [0.244, 0.725]).
Conclusion
We found no significant differences in the outcomes or major complications of uterine
preserving surgical procedures versus those which include hysterectomy in the treatment
of POP. Hysteropexy procedures may be associated with a shorter operative time and
fewer visceral injuries. This is consistent with older analyses.
Keywords
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Article info
Publication history
Published online: October 22, 2021
Accepted:
October 17,
2021
Received in revised form:
October 15,
2021
Received:
September 16,
2021
Identification
Copyright
© 2021 Elsevier B.V. All rights reserved.
