The use of synthetics in the treatment of pelvic organ prolapse

Abstract

Despite an improved understanding of pelvic anatomy and organ function and advances in surgical techniques, long-term success rates in pelvic surgery are still variable (3-59%), but can reach up to 92% in the case of associated procedures. The major causes of recurrent pelvic prolapse after corrective surgery are related to patient factors, such as poor tissues, impaired healing processes and chronic pathological increases in intra-abdominal pressure. Other causes of failure are, however, probably related to surgical techniques: the use of weak or insufficient sutures, or suboptimal performance of the surgery. In line with progress in the surgical correction of abdominal hernias, the use of synthetic mesh in pelvic reconstructive surgery also seems to guarantee its reliability, especially when autologous tissue is of poor quality or insufficient quantity. Moreover, the use of artificial mesh may simplify a surgical procedure, reducing operative time and the need for additional techniques. This review evaluates the main properties of synthetic biomaterials, their complications and the most common procedures involved in the use of synthetic mesh: the abdominal sacral colpopexy and transvaginal cystocele repair.