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Current role of mesh in vaginal prolapse surgery

Richter, Lee A.a; Carter, Charelleb; Gutman, Robert E.a

Current Opinion in Obstetrics & Gynecology: October 2014 - Volume 26 - Issue 5 - p 409–414
doi: 10.1097/GCO.0000000000000096
UROGYNECOLOGY: Edited by Narender Bhatia

Purpose of review: This report summarizes the latest literature on transvaginal mesh (TVM) for the treatment of pelvic organ prolapse, with a focus on indications for use and management of complications. We describe trends in TVM by reviewing the recent literature and summarizing national meeting presentations.

Recent findings: Vaginal mesh complications are most often managed surgically, and the majority of patients experiencing mesh-related pain have symptom improvement after intervention. New efforts will focus on identifying variables associated with success after intervention for mesh-related complications, to aid reconstructive pelvic surgeons in outcome prediction and patient counselling.

Summary: Although the use of TVM has plateaued in recent years, we are seeing an exponential rise in synthetic mesh implant removal. Reconstructive pelvic surgeons advising patients with TVM complications should report that surgical intervention is often necessary, improvement rates of pain-related symptoms after surgery are high, and up to a third may require multiple interventions.

aFemale Pelvic Medicine and Reconstructive Surgery

bDepartment of Obstetrics and Gynecology, MedStar Washington Hospital Center/Georgetown University Hospital, Washington DC, USA

Correspondence to Lee A. Richter, Female Pelvic Medicine and Reconstructive Surgery Fellow, MedStar Washington Hospital Center, 106 Irving Street NW POBS #405, Washington, DC 20010, USA. Tel: +1 202 877 6526; e-mail: Lee.Ann.Richter@medstar.net

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins