Systematic Review On Curative Effect And Postoperative Evaluation Following Pelvic Reconstruction: Uterine-preserving Or Hysterectomy: A Meta-analysis

ObjectiveThe aim of this study is to carry out a systematic review and meta-analysis tocompare the curative effect and postoperative evaluation between uterine-preservingand hysterectomy pelvic reconstruction surgery.MethodsData sources are from Ppubmed, Embase and Cochrane library (2000~2012),English language restriction. The following search strategy was used:“pelvic organprolapse”,“pelvic organ prolapse [Mesh/Embase]”,“uterovaginal prolapse”,“urogenital prolapse”,“uterine descent”,“uterus saving”,“uterus conservation”,“uterine conservation”,“uterus reserved”,“uterus preservation”,“hysterocolposacropexy hysterectomy”,“hysteropexy”,“Manchester”,“sacrospinousfixation”,“sacrospinous ligament fixation”,“intravaginal slingplasty”. According tothe inclusion and exclusion criteria, two reviewers independently screened theliterature, extracted the data and assessed the quality of all the included studies.Review Manager5.2was used to conduct this meta-analysis.ResultsA total of14literatures,1412patients were included and analyzed, among them,677patients were treated with uterine-preservation surgery,735patients werehysterectomy surgery. The hospital stays, operation duration, blood loss volume, theoccurrence of urinary incontinence and retention, the sexual life were analyzed andevaluated. The results of meta-analysis showed that the hospital stays, operationduration, blood loss volume and the occurrence of urinary incontinence are significantly reduced in uterine-preservation group. Additionally, the occurrence ofsexual dysfunction and urinary retention are equal between uterine-preserving andhysterectomy group.ConclusionThe uterine-preservation pelvic reconstruction surgery is superior tohysterectomy, by which the hospital stays, operation duration, blood loss volume andthe occurrence of urinary incontinence could be significantly reduced. However, theevaluation of patient satisfaction, for the quality and methodological limitation of theincluded studies, this conclusion needs to be further proved by multi-samples andhigh-quality RCTs.