A Systematic Review of Graft-Related Complications and recurrence following Minimally Invasive Sacrocolpopexy with a Biological Graft
Bibliographic record
Abstract
Background Biological grafts are proposed as an alternative to synthetic grafts in sacrocolpopexy (SC) to reduce complications such as graft exposure and immunologic reactions. However, concerns remain long-term durability. This systematic review and meta-analysis assess recurrence rates and graft-related complications (GRC) in minimally invasive sacrocolpopexy (MISC) using biological grafts. Objectives To evaluate the recurrence and GRC following MISC with biological grafts and to compare outcomes across different materials. Search Strategy PubMed, Embase and Cochrane databases were searched up to August 2024. Selection Criteria Studies with ≥10 patients undergoing MISC with biological grafts, reporting recurrence or GRC with ≥6 months follow-up, were included. Data Collection and Analysis Two independent reviewers assessed study quality using the Newcastle-Ottawa Scale (NOS). A random-effects meta-analysis estimated pooled recurrence and GRC with 95% confidence intervals (CI). Main Results Five studies (353 patients) met inclusion criteria. Recurrence rates ranged from 2.4% to 52.6% (pooled: 25.6% [95% CI: 8.1–48.2%]). Graft exposure occurred in 0.8% (95% CI: 0.0–4.2%). ADM had the lowest recurrence (2.4%) with no reported exposures, whereas Tutoplast® cadaveric fascia lata showed the highest recurrence (52.6%) and exposure (5.3%). The pooled reoperation rate for recurrence was 16.8% (95% CI: 0.0–51.7%). Conclusion This systematic review identified a higher recurrence rate with biological grafts in MISC than typically reported for synthetic grafts in other literature, while exposure rates appeared to be comparable. Given study heterogeneity, further research is required to determine the optimal graft choice balancing durability and complication risk.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.029 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.013 | 0.015 |
| Bibliometrics | 0.009 | 0.009 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".