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Vaginal Mesh Surgery Effective for Bladder Prolapse Repair: Report
Date:5/11/2011

By Serena Gordon
HealthDay Reporter

WEDNESDAY, May 11 (HealthDay News) -- In women, a vaginal mesh support is more effective for repairing a common type of pelvic organ prolapse -- which occurs when pelvic organs fall out of place -- than simply stitching the connective tissue in the vaginal wall muscle back together, finds new research.

But the newer procedure comes with a higher rate of serious complications during the surgery, such as bladder perforation and pelvic hemorrhage, and adverse events after the surgery, including new urinary incontinence and pain during sex, according to the study.

"It's already fairly well-known that mesh procedures have higher complications. The likelihood of hitting something you don't want to hit, like the bladder, are higher when the surgeon can't visualize everything he or she is suturing. The flip side to that is the ability to create a better support," said Dr. Scott Chudnoff, director of gynecology at Montefiore Medical Center in New York City, who was not involved in the study.

"Both traditional and novel surgical treatments for pelvic organ prolapse have advantages and disadvantages," echoed the study's lead author, Dr. Daniel Altman, an associate professor and senior consultant at Danderyd Hospital and the Karolinska Institute in Stockholm. "It is therefore essential that the patient and doctor discuss their surgical options carefully before the type and extent of surgery is decided."

Pelvic organ prolapse occurs when the pelvic organs, such as the bladder and urethra, drop downward, often because of a weakness in the vaginal wall associated with childbirth, hysterectomy or menopause. This can cause the vagina to push forward, causing discomfort and even incontinence.

The standard procedure for repairing a pelvic organ prolapse is stitching together the area of connective tissue (fascia) where there is a weakness, according to Chudnoff. This treatment, he
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