Complications of polypropylene mesh in prolapse surgery: an update

Over the last five years, there has been a considerable increase in the use of synthetic mesh to correct uterovaginal prolapse. More recently there has been an increased reporting of complications resulting in a health warning notification by the Food and Drug Administration Agency, for clinicians and the public. Evidence from recent systematic reviews supports the use of synthetic mesh for central and recurrent anterior compartment prolapse. Trials show a higher incidence of mesh related complications that can present with debilitating pain requiring reoperations and significant impact on quality of life. The lack of strict premarketing approval and post marketing surveillance along with the acceptance of the mesh without robust evidence remains an issue. It is the joint responsibility of manufacturers, clinicians and organizations to ensure that synthetic mesh is used appropriately using evidence-based data for mesh selection, usage along with post treatment surveillance.