Efficacy and safety of laparoscopic lateral suspension with mesh for pelvic organ prolapse: A systematic review and meta-analysis.

Abstract

<h4>Introduction</h4>Laparoscopic lateral suspension (LLS) with mesh is an alternative treatment for pelvic organ prolapse, offering enhanced apical vaginal suspension. This review aims to comprehensively evaluate the efficacy and safety of LLS for the treatment of pelvic organ prolapse through systematic review and meta-analysis.<h4>Material and methods</h4>Original studies including randomized controlled trials, prospective, or retrospective studies reporting outcomes on the efficacy and safety of LLS with mesh for pelvic organ prolapse were retrieved from PubMed and Web of Science up to November 30, 2024. Case reports, reviews, and non-English literature were excluded. Primary outcomes included anatomical and subjective success rates. Secondary outcomes were recurrence rates, reoperation rates, and complications. Random-effects meta-analysis was performed where appropriate. This study has been registered in PROSPERO with the registration number CRD42024620632.<h4>Results</h4>Eighteen studies (3 randomized controlled trials, 9 prospective studies, and 6 retrospective studies) involving 1430 LLS patients with a mean follow-up of 20.27 months were included. The pooled anatomical success rates for the apical and anterior compartments were 92.9% (95% confidence interval [CI]: 89.8-95.1) and 86.9% (95% CI: 81.4-90.9), respectively. The subjective success rate was 88.9% (95% CI: 85.3-91.7). The pooled recurrence rate was 9.6% (95% CI: 7.0-13.2), and the reoperation rate was 6.2% (95% CI: 4.3-8.9). Overall complication and mesh-related complication rates were 5.7% (95% CI: 3.4-9.4) and 1.9% (95% CI: 1.0-3.8), respectively. The incidence of Clavien-Dindo grade ≥3 complications was only 1.9% (16/848).<h4>Conclusions</h4>LLS demonstrates favorable anatomical and subjective success rates, indicating its reliability and safety for pelvic organ prolapse treatment. However, longer follow-up is needed to validate its long-term efficacy.