title: Selection of patients in whom vaginal graft use may be appropriate. Consensus of the 2nd IUGA Grafts Roundtable: optimizing safety and appropriateness of graft use in transvaginal pelvic reconstructive surgery.
abstract: OBJECTIVE
  The recent rapid and widespread adoption of the use of mesh, and mesh-based surgical kits for pelvic organ prolapse (POP) repair surgery has occurred largely unchecked, and is now being subjected to critical analysis and re-evaluation.
  
  
  METHODS
  There have been multiple driving forces for this phenomenon, including aggressive marketing by surgical device manufacturing companies, contagious hype among pelvic surgeons and regulatory processes which facilitated relatively rapid marketing of new devices.
  
  
  RESULTS
  Patient-related factors such as indications for mesh use, expected risks and benefits relative to mesh implantation, and appropriately selected outcome measures have been slow to be defined.
  
  
  CONCLUSIONS
  This manuscript reviews the currently available literature in the use of grafts and mesh in POP surgery with a focus on identifying situations where graft use may be appropriate for an individual patient. It also identifies specific clinical situations where mesh use may not be recommended.
authors.affiliation: Cleveland Clinic Florida, Weston, FL, USA. davilag@ccf.org
authors.forename: G Willy
authors.initials: GW
authors.lastname: Davila
authors.forename: Kaven
authors.initials: K
authors.lastname: Baessler
authors.forename: Michel
authors.initials: M
authors.lastname: Cosson
authors.forename: Linda
authors.initials: L
authors.lastname: Cardozo
mesh_terms: D005260:Female; D006801:Humans; D017063:Outcome Assessment, Health Care; D018579:Patient Selection; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods*; D018570:Risk Assessment; D013526:Surgical Mesh / Q000009:adverse effects*