Purpose of review
Over the past decade, surgical prolapse correction has evolved significantly, taking a sharp turn in 2011 when the USFDA publicly questioned synthetic graft safety. This controversy has been widely publicized and debated amongst laymen and experts alike. This review summarizes current trends in mesh implantation for prolapse repair, highlighting the impact of the current controversy.
Recent studies revealed nonmesh prolapse repair may have better outcomes than previously reported; the USFDA states there is insufficient evidence to support vaginal mesh for apical or posterior compartment prolapse; mesh prolapse repair increased over the past decade, 75% of which was placed vaginally; approximately 30% of mesh prolapse repair is performed with hysterectomy and approximately 40% is performed with concomitant incontinence repair. Anterior and apical prolapse are most likely to include mesh and of apical repair procedures, minimally invasive approaches exceed laparotomy.
This year's population-based studies describe the impact of surgeon experience, prolapse compartment, and national trends in surgical technique on mesh prolapse repair. The impact of the recent investigation on future mesh use remains unknown.