This systematic review aimed to answer: In the published RCTs on sacrocolpopexy, what is the variation on depth of dissection? This review was conducted to inform a categorization scheme for organizing and classifying sacrocolpopexy procedures.

Design:

Systematic review of literature as of March 2022.

Setting:

Scientific databases of EMBASE and Medline were queried.

Patients or Participants:

The search was limited to articles in the English language with human subjects. Only RCTs were considered for inclusion. Prospective and retrospective studies, conference proceedings, abstracts without corresponding manuscripts, and case series were excluded.

Interventions:

The methods section of each eligible RCT was reviewed by two separate researchers and categorized by depth of dissection in anterior and posterior vaginal compartments.

Measurements and Main Results:

52 articles met criteria for inclusion. In 50% of the reviewed articles (n=26), the anterior vaginal compartment depth of dissection was not described. The bladder trigone and bladder neck dissections were represented in 37% (n=19) and the proximal vagina in 13% (n=7) of studies. Regarding posterior compartment dissection, 48% (n=25) did not report a specified depth landmark. 15% of studies (n=8) describe dissection along the full length of the vagina and specify dissection to the levator ani musculature. 2% (n=1) discuss dissection along the full length of the vagina to the dorsal perineal membrane. 12% of studies described depth to the perineal body (n=6), 10% to the distal vagina (n=5), and 13% (n=7) to the proximal vagina.

Conclusion:

The depth of dissection is variable and often incompletely described in literature on SCP. A standardized classification system may be of benefit to researchers and clinicians to establish categories of SCP to improve communication and comparison regarding the procedure.