OBJECTIVE: 

To estimate the effect of concomitant supracervical hysterectomy compared with total hysterectomy during abdominal sacrocolpopexy on the rate of mesh erosion by performing a systematic review and meta-analysis of the existing literature.

DATA SOURCES: 

From database inception through January 2022, we explored MEDLINE, Web of Science, EMBASE, CINAHL, ClinicalTrials.gov, and Cochrane Central Register of Controlled Trials. Studies comparing the rate of mesh erosion in women undergoing abdominal sacrocolpopexy who had concomitant supracervical hysterectomy compared with total hysterectomy were included.

DATA EXTRACTION AND SYNTHESIS: 

Two reviewers separately ascertained studies, obtained data, and gauged study quality. The rate of mesh erosion was compared, and odds ratios (ORs) with 95% CIs were estimated.

TABULATION, INTEGRATION, AND RESULTS: 

Nineteen studies with 10,572 women who underwent abdominal sacrocolpopexy were identified, including 4,285 women in the supracervical group and 6,287 women in the total hysterectomy group. The overall mean postprocedure follow-up time was 30.7±15.1 months (median 12.4, range 1.5–44.2). The median (95% CI) point prevalence of mesh erosion was 0.36% (0–1.9%) in women who had supracervical hysterectomy compared with 3.8% (1.8–8.7%) in women who had total hysterectomy. The overall rate of mesh erosion in women who had supracervical hysterectomy was lower compared with women who had total hysterectomy (pooled OR 0.26, 95% CI 0.18–0.38, I² 0%).

CONCLUSION: 

In women with symptomatic apical pelvic organ prolapse who undergo abdominal sacrocolpopexy with concomitant hysterectomy, supracervical hysterectomy is associated with a lower risk of mesh erosion compared with total hysterectomy.

SYSTEMATIC REVIEW REGISTRATION: 

PROSPERO, CRD42022301862.

中文翻译：

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与全子宫切除术相比，骶骨阴道固定术并发宫颈上手术后网片侵蚀率：系统评价和荟萃分析

客观的： 

通过对现有文献进行系统回顾和荟萃分析，评估在腹部骶骨阴道固定术期间同时行宫颈上子宫切除术与全子宫切除术对网片侵蚀率的影响。

数据源： 

从数据库创建到 2022 年 1 月，我们探索了 MEDLINE、Web of Science、EMBASE、CINAHL、ClinicalTrials.gov和 Cochrane 对照试验中央注册中心。研究比较了接受腹部骶骨阴道固定术并同时进行宫颈上子宫切除术与全子宫切除术的女性的网状侵蚀率。

数据提取和合成： 

两名评价员分别确定研究、获取数据并评估研究质量。比较了网状侵蚀率，并估计了具有 95% CI 的比值比 (OR)。

制表、积分和结果： 

确定了 19 项涉及 10,572 名接受腹部骶骨阴道固定术的女性的研究，其中包括宫颈上手术组的 4,285 名女性和全子宫切除术组的 6,287 名女性。总体平均术后随访时间为 30.7±15.1 个月（中位数 12.4，范围 1.5-44.2）。宫颈上子宫切除术女性的网状侵蚀的中位 (95% CI) 患病率为 0.36% (0–1.9%)，而全子宫切除术女性为 3.8% (1.8–8.7%)。与接受全子宫切除术的女性相比，接受过宫颈上子宫切除术的女性网状物侵蚀的总体发生率较低（汇总 OR 0.26，95% CI 0.18–0.38，I ² 0%）。

结论： 

在接受腹部骶骨阴道固定术并同时进行子宫切除术的有症状的顶端盆腔器官脱垂的女性中，与全子宫切除术相比，宫颈上子宫切除术与较低的网状侵蚀风险相关。

系统审查注册： 

普洛斯彼罗，CRD42022301862。