Mesh‐free anterior vaginal wall repair: history or best practice?

Abstract

Key content Surgical correction of anterior vaginal wall prolapse is a common gynaecological procedure, with traditional anterior colporrhaphy changing little over the past 100 years. Within the literature, terminology is confusing, both on anatomical structures and classification of anterior vaginal wall prolapse. Synthetic meshes have become available but the evidence to support their use is limited and long‐term adverse effects are not clear. The paravaginal repair is an alternative to consider and can be approached vaginally, abdominally or laparoscopically. Learning objectives To revise the relevant anatomy of the anterior vaginal compartment and the classification of anterior vaginal wall prolapse. To review the evidence for the use of permanent mesh in pelvic floor surgery. To learn about the surgical options for correction of anterior vaginal wall prolapse without the use of vaginal mesh. Ethical issues Should permanent meshes be used for anterior vaginal wall prolapse outside a clinical research setting? Please cite this article as: McCracken GR, Lefebvre G. Mesh‐free anterior vaginal wall repair: history or best practice? The Obstetrician & Gynaecologist 2007;9:233–242.