POGP CONFERENCE 2018 Vaginal mesh and the implications of the current reluctance to use it in surgery
Pelvic organ prolapse and stress urinary incontinence are common conditions, and one in 10 women will undergo surgery for one of these complaints during their lives. The use of vaginal mesh was intended to reduce the recurrence rates of these conditions, and shorten the period of recovery from the associated symptoms, but this approach has failed to live up to expectations, especially with regard to prolapse surgery. Regulatory bodies appear to have been sluggish in responding to concerns about mesh-related complications. This has resulted in a sharp decline in its use as a result of a combination of manufacturers withdrawing their products, a rise in litigations and complaints, and intervention by central governments. This paper aims to provide an overview of mesh, the rationale for its use and how it was introduced, the complications that ensued, why there has been a change in its use in clinical practice, and what implications this could have for patients and clinicians.
Keywords: complications, pelvic organ prolapse, stress urinary incontinence, vaginal mesh