There are multiple surgical and nonsurgical approaches for treating pelvic organ prolapse (POP), and deciding which one best fits a given patient is often based on care provider preference and experience with certain techniques. With POP stages >2, marked by the vaginal wall protruding to varying degrees through the vaginal opening, many urogynecologists intervene surgically.
“In addition to conventional colporrhaphy, transvaginal mesh-based repairs had gained acceptance as a treatment option for POP over the last ten years, only to see the pendulum swing the other way secondary to fanfare surrounding postoperative complications,” explains Matthew Davies, M.D., of Penn State Hershey Obstetrics and Gynecology.
The Food and Drug Administration (FDA) issued a safety warning for mesh repair of POP, noting that mesh erosion is the most common complication, potentially requiring hospitalization and secondary re-operation.
“In addition to the risk for erosion, another complication seen with mesh-based repair is dyspareunia; unlike erosion or infection, dyspareunia may not resolve when the mesh is explanted and may be permanent. Because of these reported risks, many patients with POP are fearful and refuse to undergo a mesh-based repair,” says Davies. Continue reading