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Current trends in surgical repair of pelvic organ prolapse

Rogo-Gupta, Lisa

Current Opinion in Obstetrics & Gynecology: October 2013 - Volume 25 - Issue 5 - p 395–398
doi: 10.1097/GCO.0b013e3283648cfb
UROGYNECOLOGY: Edited by Narender Bhatia

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 findings: 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.

Summary: 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.

Division of Pelvic Medicine and Reconstruction, David Geffen School of Medicine at the University of California, Los Angeles, California, USA

Correspondence to Lisa Rogo-Gupta, MD, Division of Pelvic Medicine and Reconstruction, David Geffen School of Medicine at the University of California, Los Angeles, 200 Medical Plaza Suite 140, Box 957366, Los Angeles, CA 90095-7366, USA. Tel: +1 310 794 0206; fax: +1 310 794 0211; e-mail: lrogogupta@mednet.ucla.edu

© 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins