Risk factors for vaginal wall erosion after pelvic organ prolapse surgery with implant : a systematic review and meta-analysis

Alloplastic implants used in pelvic organ prolapse (POP) surgery can achieve good anatomical outcomes; however, concerns about complications such as vaginal wall erosion (VWE) have led to restrictions on their use. This systematic review and meta-analysis aimed to identify risk factors for VWE. A comprehensive search of three major databases (PubMed, Embase, and Central) was conducted on June 19, 2023. Eligible studies examined risk factors for VWE and reported the event rate with and without these risk factors. Odds ratios (OR) of VWE were calculated with 95% confidence intervals (CIs) for each risk factor following POP surgeries using vaginal implants. A total of 36 articles were included in the analysis. The results identified a history of smoking and concomitant hysterectomy as risk factors for VWE following POP surgeries. This information is crucial when selecting the type of surgical approach. However, further well-designed comparative studies are necessary to provide more accurate and comprehensive recommendations.