The role of synthetic mesh in the treatment of pelvic organ prolapse

Abstract

Key content:• Genital prolapse is a common indication for surgery and 30% of women treated with conventional surgery will develop recurrence of symptoms.• Innovative surgical repair techniques and systems are emerging but the search continues for the ideal procedure with guaranteed permanent success.• There is a general paucity of evidence to assist the surgeon in selecting the optimal approach. • This article addresses the role of different approaches to synthetic mesh repair in pelvic organ prolapse, their success rate and their short-and long-term morbidity. Learning objectives:• To understand the properties of synthetic mesh and the body's response.• To understand the possible roles of synthetic mesh in pelvic organ prolapse.• To be aware of the indications for use and the limitations and complications of the uses of mesh in pelvic organ prolapse. Ethical issues:• The use of synthetic mesh has not been fully evaluated in randomised controlled trials but has been widely adopted into clinical practice. Is this an example of novelty triumphing over clinical evidence?Keywords erosion / pelvic floor surgery / pelvic organ prolapse / repair / synthetic mesh Please cite this article as: Devaseelan P, Fogarty P. The role of synthetic mesh in the treatment of pelvic organ prolapse.

A Prospective Study of Minimally Invasive Paravaginal Repair of Cystocele and Associated Pelvic Floor Defects: Our Experience

“…Complications specific to mesh-like mesh erosion, retraction, infection, dyspareunia and chronic pelvic pain cannot be disregarded. Currently, there is insufficient evidence in using a permanent mesh [9]. Abdominal prolapse repair was described to be superior to vaginal repair [3].…”

Successful repair of a rectovaginal fistula caused by a tension-free vaginal mesh (TVM): a case report

“…Yoshikazu Koide 2) , Kotaro Maeda 2) , Tsunekazu Hanai 1) , Koji Masumori 1) , Hiroshi Matuoka 1) , Hidetoshi Katsuno 1) , Tomoyoshi Endo 1) , Miho Shiota 1) , Masahiro Mizuno 1) and Yeong Cheol Cheong 1)…”

“…A tension-free vaginal mesh (TVM) has been increasingly used for pelvic organ prolapse (POP) 1,2) . However, the U.S. Food and Drug Administration (FDA) released a safety communication entitled "UPDATE on Serious Complications Associated with Transvaginal Placement of Surgical Mesh for POP" in 2011 3) .…”

German S3-Guideline: Rectovaginal fistula

“…In fistulas following mesh implantation, which is now increasingly used in the treatment of pelvic floor dysfunction [41], [42], technical problems and local infections caused by the foreign materials play an important role [43], [44]. At a rate of 0.15%, these fistulas are reported as rare complications [45].…”