Hysterectomy with Minimally Invasive Sacrocolpopexy Versus Native Tissue Repair for Primary Uterovaginal Prolapse: A Systematic Review and Meta-Analysis
Systematic review reveals lower failure and retreatment with sacrocolpopexy compared to native tissue repair in uterovaginal prolapse, suggesting greater durability.
Key Points
To compare failure and retreatment rates between hysterectomy with minimally invasive sacrocolpopexy (SCP) and vaginal hysterectomy with native tissue repair (TVH + NTR) for primary uterovaginal prolapse.
Conducted a systematic review and meta-analysis (PROSPERO CRD420251171050) following PRISMA guidelines by searching MEDLINE and Embase through October 31, 2025.
Included 24 randomized trials and comparative cohort studies (≥ 30 participants) comprising 6,329 patients receiving hysterectomy with SCP and 681 receiving TVH + NTR.
Estimated pooled proportions and evaluated between-group differences via mixed-effects meta-regression, assessing quality via GRADE criteria.
Hysterectomy with SCP demonstrated significantly lower retreatment rates compared with TVH + NTR (1.59% vs 10.23%, p < 0.0001).
Composite failure occurred in 9.23% of SCP patients compared to 18.19% of TVH + NTR patients (p = 0.005).
Subjective failure (5.09% vs 17.55%, p = 0.002) and objective failure (6.80% vs 18.16%, p = 0.002) were both significantly lower in the SCP arm, with evidence certainty judged moderate to low.