| Title |
Hysteropreservation versus hysterectomy in the surgical treatment of uterine prolapse: systematic review and meta-analysis
|
|---|---|
| Published in |
International Urogynecology Journal & Pelvic Floor Dysfunction, August 2017
|
| DOI | 10.1007/s00192-017-3433-1 |
| Pubmed ID | |
| Authors |
Sofia Andrade de Oliveira, Marcelo C. M. Fonseca, Maria A. T. Bortolini, Manoel J. B. C. Girão, Matheus T. Roque, Rodrigo A. Castro |
| Abstract |
The efficacy and safety of removing or preserving the uterus during reconstructive pelvic surgery is a matter of debate. We performed a systematic review and meta-analysis of studies that compared hysteropreservation and hysterectomy in the management of uterine prolapse. PubMed, Medline, SciELO and LILACS databases were searched from inception until January 2017. We selected only randomized controlled trials and observational cohort prospective comparative studies. Primary outcomes were recurrence and reoperation rates. Secondary outcomes were: operative time, blood loss, visceral injury, voiding dysfunction, duration of catheterization, length of hospital stay, mesh exposure, dyspareunia, malignant neoplasia and quality of life. Eleven studies (six randomized and five non-randomized) were included involving 910 patients (462 in the hysteropreservation group and 448 in the hysterectomy group). Pooled data including all surgical techniques showed no difference between the groups regarding recurrence of uterine prolapse (RR 1.65, 95% CI 0.88-3.10; p = 0.12), but the risk of recurrence following hysterectomy was lower when the vaginal route was used with native tissue repair (RR 10.61; 95% CI 1.26-88.94; p = 0.03). Hysterectomy was associated with a lower reoperation rate for any prolapse compartment than hysteropreservation (RR 2.05; 95% CI 1.13-3.74; p = 0.02). Hysteropreservation was associated with a shorter operative time (mean difference -12.43 min; 95% CI -14.11 to -10.74 ; p < 0.00001) and less blood loss (mean difference -60.42 ml; 95% CI -71.31 to -49.53 ml; p < 0.00001). Other variables were similar between the groups. Overall, the rate of recurrence of uterine prolapse was not lower but the rate of reoperation for prolapse was lower following hysterectomy, while operative time was shorter and blood loss was less with hysteropreservation. The limitations of this analysis were the inclusion of nonrandomized studies and the variety of surgical techniques. The results should be interpreted with caution due to potential biases. |
Mendeley readers
The data shown below were compiled from readership statistics for 68 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 68 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Other | 8 | 12% |
| Student > Bachelor | 8 | 12% |
| Student > Postgraduate | 7 | 10% |
| Student > Ph. D. Student | 6 | 9% |
| Researcher | 5 | 7% |
| Other | 16 | 24% |
| Unknown | 18 | 26% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 34 | 50% |
| Nursing and Health Professions | 6 | 9% |
| Engineering | 2 | 3% |
| Agricultural and Biological Sciences | 1 | 1% |
| Social Sciences | 1 | 1% |
| Other | 3 | 4% |
| Unknown | 21 | 31% |
Attention Score in Context
This research output has an Altmetric Attention Score of 3. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 04 February 2020.
All research outputs
#8,537,346
of 25,382,440 outputs
Outputs from International Urogynecology Journal & Pelvic Floor Dysfunction
#887
of 2,900 outputs
Outputs of similar age
#126,256
of 327,343 outputs
Outputs of similar age from International Urogynecology Journal & Pelvic Floor Dysfunction
#17
of 34 outputs
Altmetric has tracked 25,382,440 research outputs across all sources so far. This one is in the 43rd percentile – i.e., 43% of other outputs scored the same or lower than it.
So far Altmetric has tracked 2,900 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 5.0. This one has gotten more attention than average, scoring higher than 51% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 327,343 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 53% of its contemporaries.
We're also able to compare this research output to 34 others from the same source and published within six weeks on either side of this one. This one is in the 38th percentile – i.e., 38% of its contemporaries scored the same or lower than it.