Evidence-based outcomes for mesh-based surgery for pelvic organ prolapse

Mettu, Jayadev; Colaco, Marc; Badlani, Gopal H.

doi:10.1097/mou.0000000000000063

Cited by 24 publications

(10 citation statements)

References 18 publications

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“…This is particularly true since the introduction of synthetic mesh, which seems to provide superior anatomical, functional and subjective cure rates in comparison with a surgical suspension using native tissue [13]. However, overall success rates in the long-lasting period varied greatly depending on the grade of prolapse and the compartment involved in it, and finally on the surgical approach (abdominal or vaginal route).…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Management of Vaginal Vault Prolapse Recurring after Pelvic Organ Prolapse Surgery

Mearini

Nunzi²,

Biase³

et al. 2016

Urol Int

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Introduction: Despite the increasing success of surgery for pelvic organ prolapse, recurrent vaginal vault prolapse is not rare. We present a step-by-step laparoscopic approach with a sacral colpopexy (SC) for treatment of recurrent vault prolapse. Materials and Methods: From 2006, 25 women presenting with symptomatic recurrent vault prolapse were prospectively evaluated and treated with laparoscopic SC. This article briefly describes all of the steps that are required to conduct a proper surgery in such cases. Results: After previous abdominal sacropexy, both the dissection of adherences and restoration of normal pelvic anatomy were challenging. As result, the overall operating time was longer in patients who had undergone abdominal sacropexy vs. vaginal route, p = 0.032. No significant peri- or postoperative complications were observed. At a mean follow-up of 41 months, all women presented with less than stage 2 prolapse and high levels of satisfaction. Conclusions: Despite the need for an intraoperative step-by-step surgical safety checklist, the laparoscopic repair of recurrent vault prolapse is technically feasible, safe and effective.

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Section: Discussionmentioning

confidence: 99%

Laparoscopic Management of Vaginal Vault Prolapse Recurring after Pelvic Organ Prolapse Surgery

Mearini

Nunzi²,

Biase³

et al. 2016

Urol Int

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“…Considerable attention has been paid to the anterior vaginal compartment, as it is the most common location for prolapse and also the most likely to recur after surgical repair [22]. Research has consistently found improved anatomic success with use of synthetic mesh compared to anterior colporrhaphy but no difference in patient-reported outcomes such as quality of life and dyspareunia [23][24][25].…”

Section: Evidence For and Against Mesh And Graft Use Anterior Vaginalmentioning

confidence: 98%

Native Tissue Surgery for Prolapse versus Graft/Mesh Use: Current Trends in Reconstructive Surgery

Ferrante

Kay

Kirby

2016

Curr Obstet Gynecol Rep

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Pelvic organ prolapse, characterized by a descent of the vaginal walls or vaginal apex, can be treated surgically in symptomatic women who decline or have failed conservative management. Because prolapse can recur after surgery, mesh and biologic grafts have been developed to augment repairs. Use of transvaginal mesh materials quickly increased in the early twenty-first century; however, since the FDA warnings about potential serious complications from transvaginal mesh in 2008 and 2011, use has decreased dramatically, and many mesh products were removed from the market. Even through the peak of mesh use in prolapse surgery, native tissue repairs have remained the most common type of repair.

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“…Another review [18] focusing on outcomes after mesh-based surgery reported that mesh did not cause more dyspareunia or functional symptoms than traditional repairs. It demonstrated that, the extremely poor 1-year anatomic success rates of native tissue repair for POP, progressively declined over time.…”

Section: Key Pointsmentioning

confidence: 99%