Adjuvant materials in anterior vaginal wall prolapse surgery: a systematic review of effectiveness and complications

The objective of this study is to assess the objective recurrence and complications of adjuvant materials in the treatment of anterior vaginal wall prolapse. The inclusion criteria were randomised controlled trials (RCTs) using adjuvant materials versus standard surgery for anterior vaginal wall prolapse. The main outcome measures were objective recurrence and complications. Ten RCTs (1,087 patients) were included in the systematic review. Meta-analysis showed a lower risk of objective recurrence after 1 year in the patients having an anterior repair with a biological adjuvant material (odds ratio 0.56; 95% confidence interval 0.34-0.92) and absorbable synthetic adjuvant material (odds ratio 0.44; 95% confidence interval 0.21-0.89). The evidence for the use of biological adjuvant materials in anterior vaginal wall prolapse surgery shows trends towards reduction of objective recurrence at 12 months.