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International Urogynecology Journal
Published in: International Urogynecology Journal 7/2022

02-07-2021 | Wound Infection | Original Article

Hysteropreservation versus hysterectomy in uterine prolapse surgery: a systematic review and meta-analysis

Authors: Li He, Dan Feng, Xi Zha, Xiao-Yan Liao, Zhao-Lin Gong, Ding-Qian Gu, Yong-Hong Lin, Lu Huang

Published in: International Urogynecology Journal | Issue 7/2022

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Abstract

Introduction and hypothesis

Hysteropreservation and hysterectomy for uterine prolapse have been compared in several randomized controlled trials (RCTs), as the best treatment has not been definitively determined. This study aimed to summarize the available evidence in RCTs of hysteropreservation versus hysterectomy.

Methods

We performed electronic searches in the PubMed, Embase, Cochrane Library, and China National Knowledge Infrastructure databases for eligible RCTs from inception to June 2020. The relative risks (RRs) and weighted mean differences (WMDs) with corresponding 95% confidence intervals (CIs) were calculated for categorical and continuous variables using random-effects models.

Results

Twelve RCTs involving 1177 patients were selected for meta-analysis. There were no significant differences between hysteropreservation and hysterectomy for the incidences of recurrence (RR, 0.55; 95% CI, 0.26–1.19; P = 0.130) and reoperation (RR, 1.15; 95% CI, 0.56–2.37; P = 0.705). Moreover, neither hysteropreservation nor hysterectomy had any significant effect on the risk of constipation (RR, 0.72; 95% CI, 0.15–3.46; P = 0.681), voiding dysfunction (RR, 0.99; 95% CI, 0.54–1.84; P = 0.981), intraoperative bleeding (RR, 0.35; 95% CI, 0.05–2.26; P = 0.271), upper leg dullness (RR, 0.70; 95% CI, 0.15–3.17; P = 0.643), dyspareunia (RR, 1.47; 95% CI, 0.69–3.13; P = 0.317), and wound infection (RR, 1.38; 95% CI, 0.24–7.80; P = 0.714). Furthermore, hysteropreservation was associated with less intraoperative blood loss (WMD, −25.68; 95% CI, −44.39 to −6.96; P = 0.007), shorter duration of surgery (WMD, −11.30; 95% CI, −19.04 to −3.55; P = 0.004), and shorter duration of hospitalization (WMD, −0.63; 95% CI, −1.10 to −0.16; P = 0.009) compared with hysterectomy.

Conclusion

This study found that both hysteropreservation and hysterectomy have similar effects on recurrence and reoperation rates, while hysteropreservation was superior to hysterectomy in reducing intraoperative blood loss and shortening the duration of surgery and hospitalization.
Appendix
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Metadata
Title
Hysteropreservation versus hysterectomy in uterine prolapse surgery: a systematic review and meta-analysis
Authors
Li He
Dan Feng
Xi Zha
Xiao-Yan Liao
Zhao-Lin Gong
Ding-Qian Gu
Yong-Hong Lin
Lu Huang
Publication date
02-07-2021
Publisher
Springer International Publishing
Published in
International Urogynecology Journal / Issue 7/2022
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-021-04913-9

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