Update on Mesh used for Pelvic Organ Prolapse
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2017, Vol 1, Issue 1
Abstract
In the last twenty years, we have seen mesh used initially for the treatment of urinary incontinence with great efficacy and for pelvic organ prolapse, which in some women have had a negative impact and unexpected morbidity. This has resulted in issuing of warnings by regulatory authorities [1-5] the voluntary removal of some of these products from the market, adverse publicity in the media and an impending Senate Enquiry. The inevitable outcome of this has been the concern women have of the safety of mesh used for prolapse surgery and the unfortunate consequence of questioning the benefits of the highly effective midurethral sling products used for the treatment of stress urinary incontinence. We were of the view that at this point of time it would be useful to bring you up to date on the current state of mesh products used of pelvic surgery. In modern urogynaecology, the use of mesh has become popular due to the work of Ulmsten who revolutionized incontinence surgery using sub urethral slings [6]. In 2001, Weber et al published a randomized trial comparing three techniques for anterior vaginal repair. Using a definition of success as a reduction of prolapse of 2 cm above the hymeneal remnants, success rates were significantly better in the group of patients in whom mesh was used. Based on this study, gynecologists started to use mesh when they treated pelvic organ prolapse. It was believed that mesh use improved anatomical success rates [7]. Between 2003 and 2005, several mesh products were introduced that used anchoring with mesh arms placed through the obdurate foramen, the Perigee and Anterior Prolift. The first was invented in Queensland, by two local Urogynaecologists. These meshes seemed particularly effective, even in very difficult patients, and we performed several audits which seemed promising [8-10].
Authors and Affiliations
Andrew Korda AM, Hans Peter Dietz
Keywords
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- EP ID EP567388
- DOI 10.26717/BJSTR.2017.01.000133
- Views 181
- Downloads 0
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