Pro: the contemporary use of transvaginal mesh in surgery for pelvic organ prolapse

Abstract

Purpose of review: This review will focus on the strengths of transvaginal mesh-augmented repairs over traditional native tissue repairs with an emphasis on the more recent literature.

Recent findings: Recent attention from the Food and Drug Administration has prompted a re-evaluation of the use of commercial mesh kits in pelvic organ prolapse (POP) repair. Mesh kits for POP repair were recently reclassified from Class 2 medical devices to Class 3 medical devices, a policy change that will prompt additional trials for POP repair in the future. The statements published by the FDA and the reclassification of mesh kits have generated a debate regarding the use of mesh in POP repairs.

Summary: Higher complication rates involving mesh exposures have been documented in the past leading to the recent controversy; however, current mesh studies with longer term follow-up show lower and acceptable exposures with improved objective and subjective outcomes.