Evidence map›Paper›PMID 29038834›Full record

SynthesisInternational urogynecology journal2017

The treatment of post-hysterectomy vaginal vault prolapse: a systematic review and meta-analysis.

Anne-Lotte W M Coolen, Bich Ngoc Bui, Viviane Dietz, Rui Wang, Aafke P A van Montfoort, Ben Willem J Mol, Jan-Paul W R Roovers, Marlies Y Bongers

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

Synthesis in International urogynecology journal, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 34 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
34citing papers in PubMed, 1 pooled it
6.8field-weighted citation impact, top 2% 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.

NCT04178473 nacompletednot on this mapstarted 2019, after this paper: background citation

Total Versus Subtotal Abdominal Hysterectomy at Time of Abdominal Sacrocolpopexy

TypeinterventionalSponsorSouth Valley UniversityRan2019 to 2021Enrolled70ConditionsProlapse GenitalArmstotal abdominal hysterectomy, Subtotal abdominal hysterectomy
NCT07359755 narecruitingnot on this mapstarted 2025, after this paper: background citation

A Comparative Analysis of Vaginal Mesh Surgery Versus Robotic-assisted Abdominal Mesh Surgery in the Treatment of Apical Genital Prolapse: a Prospective Randomized Non-inferiority Study.

TypeinterventionalSponsorUniversity of Sao Paulo General HospitalRan2025 to 2030Enrolled86ConditionsPelvic Organ Prolapse (POP), Pelvic Organ Prolapse Vaginal Surgery, Mesh Reinforcement, Vaginal Apex/Uterine ProlapseArmsVaginal mesh surgery for apical prolapse, Robotic-assisted abdominal mesh surgery with Upsylon device (Boston Scientific - USA) for vaginal apical prolapse
3 · Its place in the literature

Who cites it

34 citing papers in PubMed, 1 synthesis or guideline pooled it, 78 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 2 countries.

Anne-Lotte W M CoolenDepartment of Obstetrics and Gynecology, Máxima Medical Centre, De Run 4600, 5500 MB, Veldhoven, The Netherlands. anne_lotte_coolen@hotmail.com.ORCID http://orcid.org/0000-0002-0056-0804
Bich Ngoc BuiDepartment of Obstetrics and Gynecology, Máxima Medical Centre, De Run 4600, 5500 MB, Veldhoven, The Netherlands.
Viviane DietzDepartment of Obstetrics and Gynecology, Catharina Hospital, Michelangelolaan 2, 5623 EJ, Eindhoven, The Netherlands.
Rui WangRobinson Research Institute, Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia.
Aafke P A van MontfoortDepartment of Obstetrics and Gynaecology, Maastricht University, Grow School for Oncology and Developmental Biology, Minderbroedersberg 4, 6211 LK, Maastricht, The Netherlands.
Ben Willem J MolRobinson Research Institute, Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia.
Jan-Paul W R RooversDepartment of Gynecology and Obstetrics, Academic Medical Centre Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
Marlies Y BongersDepartment of Obstetrics and Gynecology, Máxima Medical Centre, De Run 4600, 5500 MB, Veldhoven, The Netherlands.
Radboud University Nijmegen · NLThe University of Adelaide · AUAmsterdam UMC Location University of Amsterdam · NLMaastricht University · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introduction and hypothesisThe treatment of post-hysterectomy vaginal vault prolapse (VVP) has been investigated in several randomized clinical trials (RCTs), but a systematic review of the topic is still lacking. The aim of this study is to compare the effectiveness of treatments for VVP.

methodsWe performed a systematic review and meta-analysis of the literature on the treatment of VVP found in PubMed and Embase. Reference lists of identified relevant articles were checked for additional articles. A network plot was constructed to illustrate the geometry of the network of the treatments included. Only RCTs reporting on the treatment of VVP were eligible, conditional on a minimum of 30 participants with VVP and a follow-up of at least 6 months.

resultsNine RCTs reporting 846 women (ranging from 95 to 168 women) met the inclusion criteria. All surgical techniques were associated with good subjective results, and without differences between the compared technique, with the exception of the comparison of vaginal mesh (VM) vs laparoscopic sacrocolpopexy (LSC). LSC is associated with a higher satisfaction rate. The anatomical results of the sacrocolpopexy (laparoscopic, robotic [RSC]. and abdominal [ASC]) are the best (62-91%), followed by the VM. However, the ranges of the anatomical outcome of VM were wide (43-97%). The poorest results are described for the sacrospinal fixation (SSF; 35-81%), which also correlates with the higher reoperation rate for pelvic organ prolapse (POP; 5-9%). The highest percentage of complications were reported after ASC (2-19%), VM (6-29%), and RSC (54%). Mesh exposure was seen most often after VM (8-21%). The rate of reoperations carried out because of complications, recurrence prolapse, and incontinence of VM was 13-22%. Overall, sacrocolpopexy reported the best results at follow-up, with an outlier of one trial reporting the highest reoperation rate for POP (11%). The results of the RSC are too small to make any conclusion, but LSC seems to be preferable to ASC.

conclusionsA comparison of techniques was difficult because of heterogeneity; therefore, a network meta-analysis was not possible. All techniques have proved to be effective. The reported differences between the techniques were negligible. Therefore, a standard treatment for VVP could not be given according to this review.

Indexed as

FemaleGynecologic Surgical ProceduresHumansHysterectomyLaparoscopyPelvic Organ ProlapsePostoperative ComplicationsSacrumSurgical MeshTreatment OutcomeVaginaPelvic organ prolapseSacrocolpopexySacrospinous fixationSurgical treatmentTrans vaginal meshTreatmentVaginal vault prolapse

Identifiers

PMID29038834
PMCPMC5705749
OpenAlexW2766887831

What Socratic holds

Textmetadata
LicenceCC BY
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.