The use of mesh in vaginal prolapse repair: do the benefits justify the risks?

Abstract

Due to the desire for improved outcomes, the use of synthetic materials in vaginal prolapse repair has been increasing despite the lack of sound evidence of their efficacy and safety. Given the limited number of randomized controlled trials evaluating repair of vaginal prolapse with the use of mesh and a paucity of data on long-term outcomes and complications, there is no clear evidence to suggest mesh should or should not be used. However, complications of mesh can range from minor to major but may lead to chronic, potentially debilitating conditions. Tailoring surgical decision-making for the individual patient must take into account and balance the patient's anatomy, symptoms, and functional status. Repairing anatomy alone is not the only important factor. The use of synthetic materials in prolapse repair demands critical examination, given the devastating complications that can occur.