What is mesh surgery for prolapse repair?
Mesh surgery for prolapse involves using a synthetic or biological mesh to reinforce weakened pelvic tissues. It can be done via the vaginal or abdominal route but is now reserved for specific cases due to potential risks and complications.
Detailed Medical Explanation
Mesh surgery was developed to provide durable repair of prolapse, especially for recurrent or severe cases. However, safety concerns—particularly for transvaginal mesh—have led to restrictions in its use in the UK and globally. Mesh is now mainly used in abdominal procedures such as laparoscopic sacrocolpopexy, which is considered safer with lower complication rates. Risks include mesh erosion, infection, pain, and need for removal. All women considering mesh should have detailed counselling and individual risk assessment. (NHS: Prolapse treatment | NICE mesh guidance)
Clinical Context
Mesh surgery is only considered after non-mesh and conservative options have been explored. Ongoing follow-up is essential after any mesh implant for early detection of complications.
Evidence-Based Approaches
NICE and NHS provide strict criteria for mesh use. All cases are reviewed by multidisciplinary teams, and comprehensive consent processes are followed. (NICE NG123)