NICE did a rapid review of the published literature on the efficacy and safety of this procedure. This comprised a comprehensive literature search and detailed review of the evidence from 7 sources, which was discussed by the committee. The evidence included 7 case series. It is presented in table 2 of the overview. Other relevant literature is in the appendix of the overview.
The specialist advisers and the committee considered the key efficacy outcomes to be: prolapse resolution, urinary symptoms, sexual function and quality of life.
The specialist advisers and the committee considered the key safety outcomes to be: intraoperative complications, mesh erosion, new urinary symptoms, chronic pain, need for mesh removal and reintervention rate.
Patient commentary was sought but none was received.
The committee noted that there was a potential risk of damage to the sacral plexus veins, and care had to be taken not to damage the sigmoid colon during the procedure.
The committee noted that this procedure may be done either by open surgery or laparoscopically.
The committee noted that this procedure has been used to treat different types of prolapse and urinary incontinence.