A standard repair of pelvic organ prolapse is safer than using mesh or grafts, researchers say today.
The Scottish study compared two controversial methods of pelvic organ prolapse repair in women with the standard approach.
Professor Cathryn Glazener of Aberdeen University, UK, and colleagues looked at outcomes after prolapse surgery using non-absorbable synthetic mesh or biological grafts, versus standard native tissue repairs.
They used figures on 1,348 women treated at 35 different hospitals across the UK, by over 100 doctors and researchers, between January 2010 and August 2013. Women had either a standard repair, repair plus mesh augmentation, or repair plus graft augmentation.
Analysis showed that mesh or graft surgery often led to complications but did not offer any clear benefits, when looked at up to two years after surgery. Its use for these procedures is an unnecessary risk, the researchers believe.
Results are published today (21 December) in The Lancet.
Professor Glazener, said: "This study showed in the first two years after surgery, there was no benefit to women having their first prolapse repair from the use of transvaginal synthetic mesh or biological graft to reinforce a standard anterior or posterior repair, either in terms of prolapse symptoms or in short term anatomical cure."
The findings contrast with the conclusions of a recent Cochrane review which reported that fewer women had prolapse symptoms with synthetic mesh than without.
"Our findings provide robust evidence on which to base counselling for surgical decision making," she adds. "However, these findings are confined to the first two years after surgery and only to women having their first repair. Longer-term follow up is required to truly assess any potential benefits or adverse effects of transvaginal mesh or graft."
Glazener, C. et al. The Lancet 21 December 2016
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