Current Urology Reports

, 12:323

Transvaginal Mesh for Prolapse Repair: What is All the Controversy About?



The use of synthetic mesh for the management of pelvic organ prolapse has been embroiled in a contentious debate over the past decade, with only more partisanship among physicians strictly against its use versus those pelvic surgeons who believe it to be a useful tool in their armamentarium. At the heart of the controversy lies the concern, by its detractors, for complications related to mesh use outweighing the as yet not rigorously tested benefit of augmenting repairs with mesh. This article discusses, in detail, the current literature supporting the use of mesh in the management of pelvic organ prolapse repair. The rising concern for complications, both simple and complex, will be addressed. This review aims to narrow the divide between physicians and to address their discordant beliefs by objectively reporting the most up-to-date data on biologic and synthetic mesh use in pelvic organ prolapse repair.


Pelvic organ prolapse Pelvic reconstructive surgery Mesh Women’s health Female urology Anterior vaginal wall prolapse Posterior vaginal wall prolapse Apical vaginal prolapse Dyspareunia Voiding dysfunction 


Papers of particular interest, published recently, have been highlighted as: •• Of major importance

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    •• Altman D, Vayrynen T, Engh ME, et al. Anterior colporrhaphy versus transvaginal mesh for pelvic-organ prolapse. N Engl J Med. 2011;364:1826–36. This represents a very recent randomized control trial comparing anterior colporrhaphy with or without mesh. It is a good example of the direction studies need to be headed to elucidate the role of mesh in pelvic reconstructive surgery. PubMedCrossRefGoogle Scholar
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    •• Maher CF, Feiner B, DeCuyper EM, et al. Laparoscopic sacral colpopexy versus total vaginal mesh for vaginal vault prolapse: a randomized trial. Am J Obstet Gynecol. 2011;204:360.e1–360.e7. This study represents a well-designed randomized controlled trial that furthers the understanding of the role of mesh repairs in managing pelvic organ prolapse. The findings are informative and will help better shape the debate on transvaginal mesh repairs. CrossRefGoogle Scholar
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    Diwadkar GB, Barber MD, Feiner B, et al. Complication and reoperation rates after apical vaginal prolapse surgical repair: a systematic review. Obstet Gynecol. 2009;113:367–73.PubMedGoogle Scholar
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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.Center for Pelvic Health and Reconstructive Surgery, The Arthur Smith Institute for UrologyHofstra North Shore-Long Island Jewish School of MedicineNew Hyde ParkUSA

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