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Vaginal mesh repair
1. is it superior to natural tissue repair
of pelvic organs prolapse?
Prof. Muhammad Aslam
Department of ObGyn
LGH, Lahore
2. ï Up to 40% of females have POP
ï About 11% of women have surgery
for POP or SUI
ï Numerous approaches that re-
approximate native tissue
ï High recurrence rates ~ 29%-40%
with suture only repairs
Vaginal Mesh Repair Prof. Aslam LGH Lahore 2
3. ï Increase longevity of repair
ï Restore anatomy
ï Prevent recurrence
Vaginal Mesh Repair Prof. Aslam LGH Lahore 3
5. ï Extrusion of mesh in the vagina
ï Erosion into the urinary tract
ï Bleeding & Infection
ï Contractures
ï Gen pelvic pain, Sexual pain
ï High rate of reoperation as a result
of these complications
Vaginal Mesh Repair Prof. Aslam LGH Lahore 5
10. ï Concerns for an increased rate of
complications associated with the
use of vaginal mesh for prolapse
Vaginal Mesh Repair Prof. Aslam LGH Lahore 10
11. ï Serious adverse events associated
with mesh use are not rare
ï Transvaginal mesh placement in
POP repair does not conclusively
improve clinical outcomes over
traditional non-mesh repair
ï Reclassification to class III devices
Vaginal Mesh Repair Prof. Aslam LGH Lahore 11
12. The Controversy:
ï Is vaginal mesh safe?
ï Which mesh to use?
Vaginal Mesh Repair Prof. Aslam LGH Lahore 12
15. ï Reports of improved results with
mesh by experienced surgeons
ï Evidence that mesh improves
objective anatomic outcomes in the
anterior compartment
ï Significant uncertainty about
safety of mesh procedure
Vaginal Mesh Repair Prof. Aslam LGH Lahore 15
16. ï Current data are insufficient to
answer important questions
ï Well designed RCTs are needed
Vaginal Mesh Repair Prof. Aslam LGH Lahore 16
17. ï Routine mesh placement in all
patients is not necessary
ï Informed consent
ï Proper training before attempting
mesh repairs
Vaginal Mesh Repair Prof. Aslam LGH Lahore 17
