Evidence map›Paper›PMID 27696355›Full record

SynthesisThe Cochrane database of systematic reviews2016

Surgery for women with apical vaginal prolapse.

Christopher Maher, Benjamin Feiner, Kaven Baessler, Corina Christmann-Schmid, Nir Haya, Julie Brown

5 registry-linked trialsOpen access · bronzeAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in The Cochrane database of systematic reviews, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 5 registered trials, which are not on this map. Cited by 171 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
171citing papers in PubMed, 10 pooled it
35.6field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03445442 completednot on this map

Different Surgical Techniques Used for Prolapse Repair in Elderly Patient

TypeobservationalSponsorCentre Hospitalier Universitaire de NiceRan2011 to 2017Enrolled214ConditionsUnrecognized ConditionArmsSCP, NTR, VMR
NCT03644628 naunknown statusnot on this mapstarted 2019, after this paper: background citation

Laparoscopic Lateral Suspension Versus Laparoscopic Sacral Colpopexy for Anterior and Apical Prolapse: an International Multicentric Randomized Trial

TypeinterventionalSponsorMedical University of ViennaRan2019 to 2024Enrolled200ConditionsPelvic Organ ProlapseArmsLaparoscopic repair of anterior and apical pelvic organ prolapse
NCT04139083 completednot on this map

The Clinical and Urodynamic Effects of Transvaginal or Laparoscopic Mesh Suspension for the Treatment of Pelvic Organ Prolapse

TypeobservationalSponsorKaohsiung Medical University Chung-Ho Memorial HospitalRan2012 to 2018Enrolled466ConditionsPelvic Organ ProlapseArmsLSC mesh suspension, TVM
NCT04551859 naunknown statusnot on this mapstarted 2020, after this paper: background citation

Concordance of Pelvic Organ Mobility Measurements Between the Finite Element Model and the Dynamic Pelvic Floor MRI in Patients Undergoing a Sacrospinous Ligament Fixation Surgery

TypeinterventionalSponsorCentre Hospitalier Universitaire de BesanconRan2020 to 2021Enrolled41ConditionsSacrospinofixation, Apical ProlapseArmsDynamic Pelvic Floor MRI
NCT05969067 nacompletednot on this mapstarted 2023, after this paper: background citation

Comparing Retroperitoneal Tunneling Versus Dissection Technique During Robotic Assisted Sacrocolpopexy for Pelvic Organ Prolapse

TypeinterventionalSponsorThe University of Texas Medical Branch, GalvestonRan2023 to 2024Enrolled40ConditionsPelvic Organ ProlapseArmsTunneling Technique during RA SCP, Dissection Technique during RA SCP
3 · Its place in the literature

Who cites it

171 citing papers in PubMed, 10 syntheses or guidelines pooled it, 384 citations in OpenAlex.

  1. Transvaginal mesh or grafts or native tissue repair for vaginal prolapse.The Cochrane database of systematic reviews · 2024
    Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
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  6. Pessaries (mechanical devices) for managing pelvic organ prolapse in women.The Cochrane database of systematic reviews · 2020
    Pooled it
  7. Guideline
  8. Pooled it
  9. Pooled it
  10. Pooled it
  11. Trial
  12. Trial
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  14. Efficacy of Sacrospinous Fixation or Uterosacral Ligament Suspension for Pelvic Organ Prolapse in Stages III and IV: Randomized Clinical Trial.Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia · 2023
    Trial
  15. Trial
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  18. Surgical interventions for uterine prolapse and for vault prolapse: the two VUE RCTs.Health technology assessment (Winchester, England) · 2020
    Trial
  19. Trial
  20. Trial

111 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors at 6 institutions in 5 countries.

Christopher MaherRoyal Brisbane Women's Hospital, University Queensland, Brisbane, Queensland, Australia.
Benjamin Feiner
Kaven Baessler
Corina Christmann-Schmid
Nir Haya
Julie Brown
Carmel Medical Center · ILCharité - Universitätsmedizin Berlin · DEHillel Yaffe Medical Center · ILRoyal Brisbane and Women's Hospital · AUUniversity of Auckland · NZUniversity of Lucerne · CH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundApical vaginal prolapse is a descent of the uterus or vaginal vault (post-hysterectomy). Various surgical treatments are available and there are no guidelines to recommend which is the best.

objectivesTo evaluate the safety and efficacy of any surgical intervention compared to another intervention for the management of apical vaginal prolapse. SEARCH

methodsWe searched the Cochrane Incontinence Group's Specialised Register of controlled trials, which contains trials identified from the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, ClinicalTrials.gov, WHO ICTRP and handsearching of journals and conference proceedings (searched July 2015) and ClinicalTrials.gov (searched January 2016). SELECTION CRITERIA: We included randomised controlled trials (RCTs). DATA COLLECTION AND ANALYSIS: We used Cochrane methods. Our primary outcomes were awareness of prolapse, repeat surgery and recurrent prolapse (any site). MAIN

resultsWe included 30 RCTs (3414 women) comparing surgical procedures for apical vaginal prolapse. Evidence quality ranged from low to moderate. Limitations included imprecision, poor methodological reporting and inconsistency. Vaginal procedures versus sacral colpopexy (six RCTs, n = 583; one to four-year review). Awareness of prolapse was more common after vaginal procedures (risk ratio (RR) 2.11, 95% confidence interval (CI) 1.06 to 4.21, 3 RCTs, n = 277, I AUTHORS'

conclusionsSacral colpopexy is associated with lower risk of awareness of prolapse, recurrent prolapse on examination, repeat surgery for prolapse, postoperative SUI and dyspareunia than a variety of vaginal interventions.The limited evidence does not support use of transvaginal mesh compared to native tissue repair for apical vaginal prolapse. Most of the evaluated transvaginal meshes are no longer available and new lighter meshes currently lack evidence of safetyThe evidence was inconclusive when comparing access routes for sacral colpopexy.No clear conclusion can be reached from the available data comparing uterine preserving surgery versus vaginal hysterectomy for uterine prolapse.

Indexed as

AgedAwarenessDyspareuniaFemaleHumansHysterectomyMiddle AgedRandomized Controlled Trials as TopicRecurrenceReoperationSurgical MeshTreatment OutcomeUrinary Incontinence, StressUterine ProlapseVagina

Identifiers

PMID27696355
PMCPMC6457970
OpenAlexW2529845321

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.