At Milton Keynes University Hospital we do not use vaginal meshes for primary prolapse surgery due to higher complication rates when compared to non-mesh repairs.
It is not recommended by the Royal College of Obstetricians and Gynaecologists (RCOG) and the British Society of Urogynaecologists (BSUG) as first line treatment for vaginal prolapse and the evidence behind the potential risk and benefits is still awaited.
Our urogynaecologists use vaginal sub-urethral slings for management of stress incontinence and laparoscopic (keyhole)/abdominal meshes for recurrent prolapse or prolapsed uterus. Alternative treatment options are available for these conditions and women have the right to choose their options.
National Institute for Clinical Excellency (NICE) is drafting a guideline for usage of vaginal meshes for prolapse surgery.
This NICE IPG refers only to the use of mesh to reinforce pelvic organ prolapse repair for anterior and posterior wall prolapse. It does not refer to the use of mesh or tape for stress urinary incontinence or vaginal vault surgery which are subject to different NICE IPG’s ( Interventional Procedure Guideline).
The National Institute for Clinical Excellency (NICE) is drafting a guideline for usage of vaginal meshes for prolapse surgery. The NICE Clinical Guideline on Urinary Incontinence and Pelvic Organ Prolapse is due to be published in 2019.
Mr Edward Morris, vice president for clinical quality at the Royal College of Obstetricians and Gynaecologists, said: “This guidance from NICE recommends that vaginal placement of mesh to repair prolapse should only be used in the context of research. Current evidence does not recommend the routine use of mesh to treat prolapse as the first surgical intervention, due to higher complication rates when compared to non-mesh repairs. Therefore this guidance is consistent with the majority of UK current clinical practice.”
If you are a patient and have any concerns, do discuss this at your next appointment.