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Biologic Grafts and Synthetic Meshes in Pelvic Reconstructive Surgery

CHEN, CHI CHIUNG GRACE MD; RIDGEWAY, BERI MD; PARAISO, MARIE FIDELA R. MD

Clinical Obstetrics & Gynecology: June 2007 - Volume 50 - Issue 2 - pp 383-411
doi: 10.1097/GRF.0b013e31804b184c
Current Controversies in Gynecology

Despite the lack of evidence, augmenting pelvic organ prolapse surgery with biologic graft or synthetic mesh is increasing. The objective of this review is to examine the available grafts and meshes and discuss the current data addressing the use of these implants in correction of apical, anterior, and posterior prolapse. Most of the studies are retrospective with few randomized controlled trials. There is level I evidence suggesting that repair of apical prolapse with abdominal sacral colpopexy using synthetic mesh results in improved outcomes. However, most of the data concerning graft or mesh incorporation in anterior or posterior repairs do not support augmentation with prosthesis.

Department of Obstetrics Gynecology, Cleveland Clinic, Cleveland, Ohio

Correspondence: Marie Fidela R. Paraiso, MD, Department of Obstetrics Gynecology, Cleveland Clinic, 9500 Euclid Avenue, A81, Cleveland, OH 44195. E-mail: paraism@ccf.org

© 2007 Lippincott Williams & Wilkins, Inc.