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Vaginal mesh repair

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Vaginal mesh repair

  1. 1. is it superior to natural tissue repair of pelvic organs prolapse? Prof. Muhammad Aslam Department of ObGyn LGH, Lahore
  2. 2.  Up to 40% of females have POP About 11% of women have surgery for POP or SUI Numerous approaches that re- approximate native tissue High recurrence rates ~ 29%-40% with suture only repairs Vaginal Mesh Repair Prof. Aslam LGH Lahore 2
  3. 3.  Increase longevity of repair Restore anatomy Prevent recurrence Vaginal Mesh Repair Prof. Aslam LGH Lahore 3
  4. 4. Vaginal Mesh Repair Prof. Aslam LGH Lahore 4
  5. 5.  Extrusion of mesh in the vagina Erosion into the urinary tract Bleeding & Infection Contractures Gen pelvic pain, Sexual pain High rate of reoperation as a result of these complications Vaginal Mesh Repair Prof. Aslam LGH Lahore 5
  6. 6. Vaginal Mesh Repair Prof. Aslam LGH Lahore 6
  7. 7. Vaginal Mesh Repair Prof. Aslam LGH Lahore 7
  8. 8. Vaginal Mesh Repair Prof. Aslam LGH Lahore 8
  9. 9. Vaginal Mesh Repair Prof. Aslam LGH Lahore 9
  10. 10.  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. 11.  Serious adverse events associated with mesh use are not rare Transvaginal mesh placement in POP repair does not conclusively improve clinical outcomes over traditional non-mesh repair Reclassification to class III devices Vaginal Mesh Repair Prof. Aslam LGH Lahore 11
  12. 12. The Controversy:  Is vaginal mesh safe?  Which mesh to use? Vaginal Mesh Repair Prof. Aslam LGH Lahore 12
  13. 13. Lawyer@confused.com Vaginal Mesh Repair Prof. Aslam LGH Lahore 13
  14. 14. Vaginal Mesh Repair Prof. Aslam LGH Lahore 14
  15. 15.  Reports of improved results with mesh by experienced surgeons Evidence that mesh improves objective anatomic outcomes in the anterior compartment Significant uncertainty about safety of mesh procedure Vaginal Mesh Repair Prof. Aslam LGH Lahore 15
  16. 16.  Current data are insufficient to answer important questions Well designed RCTs are needed Vaginal Mesh Repair Prof. Aslam LGH Lahore 16
  17. 17.  Routine mesh placement in all patients is not necessary Informed consent Proper training before attempting mesh repairs Vaginal Mesh Repair Prof. Aslam LGH Lahore 17
  18. 18. Vaginal Mesh Repair Prof. Aslam LGH Lahore 18
  19. 19. Thank You Vaginal Mesh Repair Prof. Aslam LGH Lahore 19

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