title: Are recurrence rates for "traditional" transvaginal prolapse repairs really that high? What does the evidence show?
abstract: Pelvic organ prolapse (POP) is a common and bothersome condition. Multiple methods for surgical repair exist, and much attention has been given to improving the efficacy of repair by implementing mesh interposition. Standard (native tissue-based) repairs in the anterior compartment have long been thought to be associated with high anatomical recurrence rates and the currently available randomized controlled trials (RCTs) support this thinking. However, subjective improvement in pelvic pressure and bulging and quality of life indices are similarly improved in both standard and mesh-augmented repairs. No RCTs are available to compare standard and mesh-augmented repairs in the posterior compartment. Despite the presence of RCTs, the data is often inconsistent and questions remain regarding the optimal criteria to describe POP recurrence. While there is a role for both types of repair, the optimal patient scenario is not known.
authors: Louisiana State University Health - Shreveport, 1501 Kings Highway, Shreveport, LA 71130, USA. agomel@lsuhsc.edu
authors: Alex
authors: A
authors: Gomelsky
authors: Randy
authors: R
authors: Vince
mesh_terms: D005260:Female; D006801:Humans; D057605:Natural Orifice Endoscopic Surgery / Q000379:methods*; D056887:Pelvic Organ Prolapse / Q000601:surgery; D012008:Recurrence; D013526:Surgical Mesh; D016896:Treatment Outcome; D014596:Uterine Prolapse / Q000601:surgery*
references: Int Urogynecol J Pelvic Floor Dysfunct. 2006 Feb;17(2):195-201
references: 15915320
references: Obstet Gynecol. 1997 Apr;89(4):501-6
references: 9083302
references: BJOG. 2008 Oct;115(11):1350-61
references: 18715243
references: Obstet Gynecol. 2010 Aug;116(2 Pt 1):293-303
references: 20664388
references: Am J Obstet Gynecol. 2005 Mar;192(3):795-806
references: 15746674
references: Am J Obstet Gynecol. 1996 Dec;175(6):1423-30; discussion 1430-1
references: 8987920
references: Am J Obstet Gynecol. 1992 Jun;166(6 Pt 1):1717-24; discussion 1724-8
references: 1615980
references: Am J Obstet Gynecol. 1992 Jun;166(6 Pt 1):1764-8; discussion 1768-71
references: 1615985
references: Am J Obstet Gynecol. 1998 Dec;179(6 Pt 1):1451-6; discussion 1456-7
references: 9855580
references: Am J Obstet Gynecol. 1999 Dec;181(6):1360-3; discussion 1363-4
references: 10601913
references: Am J Obstet Gynecol. 2003 Nov;189(5):1261-7
references: 14634551
references: Am J Obstet Gynecol. 2010 Sep;203(3):235.e1-8
references: 20494332
references: BJOG. 2009 Sep;116(10):1380-6
references: 19583714
references: N Engl J Med. 2011 May 12;364(19):1826-36
references: 21561348
references: BJOG. 2011 Nov;118(12):1518-27
references: 21864325
references: Obstet Gynecol. 2004 Oct;104(4):685-9
references: 15458886
references: Int Urogynecol J Pelvic Floor Dysfunct. 2006 Jun;17 Suppl 1:S51-5
references: 16738750
references: Int Urogynecol J Pelvic Floor Dysfunct. 2008 Apr;19(4):467-71
references: 17901910
references: Obstet Gynecol. 2008 Nov;112(5):1131-42
references: 18978116
references: Obstet Gynecol. 2009 Sep;114(3):600-609
references: 19701041
references: Am J Obstet Gynecol. 2012 Jan;206(1):86.e1-9
references: 21974992
references: Arch Gynecol Obstet. 2012 Oct;286(4):965-72
references: 22648445
references: Obstet Gynecol. 2008 Apr;111(4):891-8
references: 18378748
references: Obstet Gynecol. 2003 Feb;101(2):320-4
references: 12576256
references: Am J Obstet Gynecol. 2001 Jun;184(7):1496-501; discussion 1501-3
references: 11408873
references: Rev Col Bras Cir. 2009 Jul;36(3):210-6
references: 20076900
references: J Urol. 2010 Nov;184(5):2029-34
references: 22520004
references: Obstet Gynecol. 2011 Dec;118(6):1337-1344
references: 22067717
references: Cochrane Database Syst Rev. 2010 Apr 14;(4):CD004014
references: 20393938
references: Obstet Gynecol. 2011 Feb;117(2 Pt 1):242-250
references: 21252735
references: Obstet Gynecol. 2009 Dec;114(6):1278-1283
references: 19935030