Women navigating pelvic organ prolapse treatment options must decide whether or not to utilize non-surgical or surgical treatment.There truly is no right or wrong choice regarding surgical or non-surgical treatment options; the preference for your personal backdrop is the right choice if it's the right choice for you.
Use of mesh for pelvic organ prolapse surgery can reduce the risk of additional surgery down the road. For those who opt for surgical treatment, APOPS recommends seeking a female pelvic medicine reconstructive surgeon (FPMRS) urogynecologist or urologist. These surgeons specialize in women's pelvic health, pivotal for POP procedures just as an oncologist is for breast cancer or neurologist for multiple sclerosis (MS) or brain tumors-it reducing the risk of complications. A dialogue should be initiated between patient and surgeon whether or not to utilize mesh for your repair. Research your procedure choices, ask your physician ALL questions you have, discuss your options regarding transvaginal mesh repair (through the vagina), robotic or laproscopic procedures, or abdominal mesh repair. In 2011, the FDA issued a warning relating to concerns about transvaginal mesh procedure complications. Urogynecologists and urologists with an additional 2-3 years of fellowship training are the most logical surgeon choice for these intricate procedures. Additionally, it is a good idea to check the records of your individual physician to make sure you have found the right physician for your specific needs. We all need to know our options; there are choices regarding surgical procedures just as there are options whether or not to utilize surgical procedures at all. Ask all questions you have; a physician who will not take the time to address your concerns with this intricate procedure is not the physician of choice.
Some urogynecologists and urologists refuse to utilize mesh procedures; it is a personal preference the specialists in the field make on a one-on-one basis based on their individual concerns. A significant percentage of urogynecologists and urologists who utilize mesh feel transvaginal mesh procedures are a beneficial option. I am a woman whose surgical procedure was transvaginal mesh placement in February 2008. I have been very happy with the outcome; as a woman who is extremely active, I wanted my POP repair to be a one time event rather than worrying about potential for additional POP surgical intervention down the road.
Small incisions, proper mesh insertion location, preparation of mesh insertion site, use of estrogen cream pre and post-surgery, degree of mesh tension, and a two layer closure are important considerations for a quality mesh procedure, whether a surgeon performs mesh surgery through a transvaginal, robotic, or abdominal incision.
Articles by Sherrie Palm
Women who have concerns related to mesh procedures can post their questions to the APOPS Forum, a secure Facebook forum accessible only to members and women's pelvic health clinicians. Women with POP navigating treatment options, women post surgery both with mesh and without, women who prefer to utilize non-surgical treatment options, and multiple healthcare professionals share insights with each other in our protected environment.
As studies on long term efficacy of mesh become available, APOPS will post them on this page.
Long term follow-up of sacrocolpopexy mesh implants at two time intervals at least one year apart using 4D transperineal ultrasound Feb 2016
ICS/IUGA Prosthesis/Graft Complication Classification Chart
The link below is the IUGA commentary on the European Commission report regarding mesh.