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New Guideline for Transvaginal Mesh Procedures for Pelvic Organ Prolapse

The Society of Obstetricians and Gynaecologists (SOGC) has released the clinical practice guideline, Transvaginal Mesh Procedures for Pelvic Organ Prolapse, which reviews the risks and benefits of these repairs and updates recommendations first made in 2011.  

The new guideline says transvaginal mesh still has an important use in urogynaecology in select cases because it can improve anatomical outcomes, especially for women with recurrent prolapse and for those with risk factors for failure after native tissue repairs. But, because it can also be associated with an increased risk of reoperation, mesh exposure, and pain, clinicians must also thoroughly weigh the pros and cons of using it and provide thorough preoperative counselling to their patients.

Pelvic organ prolapse is a common disorder that affects up to 50% of women of all ages. It occurs when a pelvic organ, like the bladder, drops (or prolapses) from its normal position and pushes against the wall of the vagina. The muscles holding these organs weaken or stretch, usually because of childbirth, a vaginal trauma or family history. Many women with mild symptoms can improve the condition by avoiding heavy lifting, or doing Kegel exercises, for example. Others may require some kind of surgery.