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Selection of patients in whom vaginal graft use may be appropriate

Consensus of the 2nd IUGA Grafts Roundtable: Optimizing Safety and Appropriateness of Graft Use in Transvaginal Pelvic Reconstructive Surgery

  • IUGA Grafts Roundtable 2010
  • Published:
International Urogynecology Journal Aims and scope Submit manuscript

Abstract

Introduction and hypothesis

The recent rapid and widespread adoption of the use of mesh, and mesh-based surgical kits for pelvic organ prolapse (POP) repair surgery has occurred largely unchecked, and is now being subjected to critical analysis and re-evaluation.

Methods

There have been multiple driving forces for this phenomenon, including aggressive marketing by surgical device manufacturing companies, contagious hype among pelvic surgeons and regulatory processes which facilitated relatively rapid marketing of new devices.

Results

Patient-related factors such as indications for mesh use, expected risks and benefits relative to mesh implantation, and appropriately selected outcome measures have been slow to be defined.

Conclusions

This manuscript reviews the currently available literature in the use of grafts and mesh in POP surgery with a focus on identifying situations where graft use may be appropriate for an individual patient. It also identifies specific clinical situations where mesh use may not be recommended.

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Conflicts of interest

G. Willy Davila is a speaker, consultant, and grant recipient of Astellas, CL Medical, and AMS, and a consultant for Coloplast, Teva, and Israel Biomedical Innovations. Michel Cosson is a lecturer and has a patent in process with Ethicon, has a patent in process with Cousin Biotech, and is a lecturer at Ipsen and Olympus. Linda Cardozo is a speaker, consultant, or researcher at Pfizer, Astellas, and Teva. Dr. Kaven Baessler has no conflict of interest.

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Authors and Affiliations

  1. Cleveland Clinic Florida, Weston, FL, USA

    G. Willy Davila

  2. Charite University Hospital, Berlin, Germany

    Kaven Baessler

  3. Hospital Jeanne de Flandres, Lille, France

    Michel Cosson

  4. Urogynaecology Unit, King’s College Hospital, London, UK

    Linda Cardozo

  5. Department of Gynecology, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd., Weston, FL, 33331, USA

    G. Willy Davila

Authors
  1. G. Willy Davila
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  2. Kaven Baessler
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  3. Michel Cosson
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  4. Linda Cardozo
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Correspondence to G. Willy Davila.

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Davila, G.W., Baessler, K., Cosson, M. et al. Selection of patients in whom vaginal graft use may be appropriate. Int Urogynecol J 23 (Suppl 1), 7–14 (2012). https://doi.org/10.1007/s00192-012-1677-3

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  • DOI: https://doi.org/10.1007/s00192-012-1677-3

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