Mesh for Anterior Pelvic Organ Prolapse: Where Do We Go Now?

Abstract

Pelvic organ prolapse (POP) repair using native tissue has a significant risk of failure, especially for anterior compartment repair. Surgical techniques using a variety of mesh grafts and approaches have been developed to decrease the risk of recurrence and improve overall outcomes. Some, but not all, studies have demonstrated that synthetic mesh grafts and mesh kits improve objective outcomes. However, reports of complications with the use of synthetic mesh grafts and mesh kits have been emerging. Such reports have stirred the interests of physicians, medical societies, the media, and regulatory agencies such as the US Food and Drug Administration (FDA), which in July 2011 issued a Safety Communication updating a 2008 statement warning about synthetic mesh and mesh kit complications associated with POP repair. This article discusses current and future directions using synthetic mesh for anterior compartment POP repair in the context of the recent FDA communication.