Introduction: Pelvic organ prolapse (POP) is characterised by the descent or herniation of the uterus, vaginal vault, bladder or bowel into the interior or even out of the vagina. This condition does not cause mortality but can have a great impact on quality of life. It can affect up to 50% of women who have had vaginal births, and can give rise to symptoms in 21% of cases. The aetiology of POP is complex and multifactorial, with the main risk factors being vaginal birth, advanced age and obesity. The therapeutic options are conservative treatment, mechanical or surgical intervention. The latter constitutes the basis of POP repair, particularly for prolapses that are symptomatic or occur at an advanced stage, and has recently incorporated the use of synthetic non-absorbable mesh. This mesh has been associated with different complications, as reported by bodies that have issued alerts regarding its use, such as the Food and Drug Administration (FDA) in 2011, which advises health professionals and patients about the risks of using mesh, including vaginal erosion, pain, infection, urinary complications, bleeding and perforation of organs.
Objectives: To assess the safety, effectiveness and cost of using transvaginal mesh in the surgical repair of POP.
Methods: We conducted a systematic review with a search of the scientific literature from March-April 2013, stipulating no time limit and covering all leading biomedical databases specialised in systematic reviews (Health Technology Assessment, Centre for Reviews and Dissemination, Database of Abstracts of Reviews of Effectiveness, NHS Economic Evaluation Database, Cochrane Library Plus), as well as general databases such as Medline and Embase. The search strategy included the terms, "pelvic organ prolapse" and "transvaginal mesh", among others. Insofar as the type of study was concerned, we only selected systematic reviews, meta-analyses, clinical practice guidelines and randomised controlled trials (RCTs).
Results and discussion: See pdf below.