Reasons for and Against Use of Non-absorbable, Synthetic Mesh During Pelvic Organ Prolapse Repair, According to the Prolapsed Compartment
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- 作者：Stavros Kontogiannis ; Evangelia Goulimi ; Konstantinos Giannitsas
- 关键词：Anterior compartment ; Apical compartment ; Mesh repair ; Native tissue repair ; Non ; absorbable synthetic mesh ; Pelvic organ prolapse ; Posterior compartment ; Urology
- 刊名：Advances in Therapy
- 出版年：2017
- 出版时间：January 2017
- 年：2017
- 卷：33
- 期：12
- 页码：2139-2149
- 全文大小：480KB
- 刊物主题：Internal Medicine; Oncology; Cardiology; Rheumatology; Endocrinology; Pharmacology/Toxicology;
- 出版者：Springer Healthcare
- ISSN：1865-8652
- 卷排序：33
文摘
Awareness and reporting of mesh-related complications of pelvic organ prolapse repairs have increased in recent years. As a result, deciding whether to use a mesh or not has become a difficult task for urogynecologists. Our aim was to summarize reasons for and against the use of mesh in prolapse repair based on a review of relevant literature. Scopus and PubMed databases were searched for papers reporting on the efficacy and safety of native tissue versus non-absorbable, synthetic mesh prolapse repairs. Randomized controlled trials, systematic reviews, and meta-analyses were included. Evidence is presented for each vaginal compartment separately. In the anterior compartment, mesh repairs seem to offer clearly superior efficacy and durability of results compared to native tissue repairs, but with an equally clear increase in complication rates. In the isolated posterior compartment prolapse, high-quality evidence is sparse. As far as the apical compartment is concerned, sacrocolpopexy is the most efficacious, yet the most invasive procedure. Data on the comparison of transvaginal mesh versus native tissue repairs of the apical compartment are somewhat ambiguous. Given the inevitable coexistence of advantages and disadvantages of mesh use in each of the prolapsed vaginal compartments, an individualized treatment decision, based on weighing risks against benefits for each patient, seems to be the most rational approach.