Long-term outcomes of vaginal mesh versus native tissue repair for anterior vaginal wall prolapse

Vaginal mesh augmentation for anterior prolapse was associated with a significantly higher 5-year risk of any repeat surgery compared with native tissue repair (15.2% vs 9.8%, p<0.0001; adjusted HR 1.

Effect: adverse; HR 1.33; CI: 95%CI 1.20, 1.46

Vaginal mesh did not reduce the 5-year risk of surgery for recurrent prolapse compared with native tissue repair (10.4% vs 9.3%, p=0.70; adjusted HR 0.93, 95%CI 0.83-1.05), despite evidence from rando

Effect: null; HR 0.93; CI: 95%CI 0.83, 1.05

Vaginal mesh augmentation carried a 5.9% 5-year risk of surgery for mesh complications (vs 0.7% in native tissue, p<0.0001; adjusted HR 8.21, 95%CI 6.31-10.67), with the risk increasing over calendar

Effect: adverse; HR 8.21; CI: 95%CI 6.31, 10.67

Concurrent hysterectomy decreased the 2-year risk of surgery for recurrent prolapse in the native tissue group (4.4% vs 7.8%), and recent/concurrent sling decreased recurrence risk in both native tiss

Effect: improvement; 4.4% with concurrent hysterectomy vs 7.8% without (native tissue group); CI: 95%CI with hysterectomy 3.9-4.9; without hysterectomy 7.3-8.