Central Compartment and Apical Defect Repair Using Synthetic Mesh
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Pelvic organ prolapse is an increasingly common condition for women that has been challenging to treat due to high recurrence rates after surgical repair. The introduction of mesh-augmented prolapse repairs as a means to achieve more robust repairs had great initial promise. As more data emerge on outcomes and novel mesh complications, the when and where of mesh augmentation has become much less clear. This article reviews the relevant literature on the use of mesh in central and apical repairs. This includes a detailed look at the available data for vaginal mesh kits and several recent trials comparing mesh kits to traditional repairs. The article ends with a discussion of the recent U.S. Food and Drug Administration (FDA) safety communication on the use of transvaginal mesh in pelvic organ prolapse and the authors’ views of how practice may change in this new environment.
KeywordsMesh Pelvic organ prolapse Stress urinary incontinence Anterior sacrocolpopexy Randomized controlled trials FDA Anterior colporrhaphy Quality of life Female urology
K. Soules: none. Dr. J. Christian Winters has served as a consultant for Astellas and Pfizer. Dr. Christopher J. Chermansky has served as a consultant and on the speakers bureaus for Astellas and Allergan; and was a trial investigator on behalf of Contura.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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