1. is it superior to natural tissue repair
of pelvic organs prolapse?
Prof. Muhammad Aslam
Department of ObGyn
LGH, Lahore

2.  Up to 40% of females have POP
 About 11% of women have surgery
for POP or SUI
 Numerous approaches that re-
approximate native tissue
 High recurrence rates ~ 29%-40%
with suture only repairs
Vaginal Mesh Repair Prof. Aslam LGH Lahore 2

3.  Increase longevity of repair
 Restore anatomy
 Prevent recurrence
Vaginal Mesh Repair Prof. Aslam LGH Lahore 3

4. Vaginal Mesh Repair Prof. Aslam LGH Lahore 4

5.  Extrusion of mesh in the vagina
 Erosion into the urinary tract
 Bleeding & Infection
 Contractures
 Gen pelvic pain, Sexual pain
 High rate of reoperation as a result
of these complications
Vaginal Mesh Repair Prof. Aslam LGH Lahore 5

6. Vaginal Mesh Repair Prof. Aslam LGH Lahore 6

7. Vaginal Mesh Repair Prof. Aslam LGH Lahore 7

8. Vaginal Mesh Repair Prof. Aslam LGH Lahore 8

9. Vaginal Mesh Repair Prof. Aslam LGH Lahore 9

10.  Concerns for an increased rate of
complications associated with the
use of vaginal mesh for prolapse
Vaginal Mesh Repair Prof. Aslam LGH Lahore 10

11.  Serious adverse events associated
with mesh use are not rare
 Transvaginal mesh placement in
POP repair does not conclusively
improve clinical outcomes over
traditional non-mesh repair
 Reclassification to class III devices
Vaginal Mesh Repair Prof. Aslam LGH Lahore 11

12. The Controversy:
 Is vaginal mesh safe?
 Which mesh to use?
Vaginal Mesh Repair Prof. Aslam LGH Lahore 12

13. Lawyer@confused.com
Vaginal Mesh Repair Prof. Aslam LGH Lahore 13

14. Vaginal Mesh Repair Prof. Aslam LGH Lahore 14

15.  Reports of improved results with
mesh by experienced surgeons
 Evidence that mesh improves
objective anatomic outcomes in the
anterior compartment
 Significant uncertainty about
safety of mesh procedure
Vaginal Mesh Repair Prof. Aslam LGH Lahore 15

16.  Current data are insufficient to
answer important questions
 Well designed RCTs are needed
Vaginal Mesh Repair Prof. Aslam LGH Lahore 16

17.  Routine mesh placement in all
patients is not necessary
 Informed consent
 Proper training before attempting
mesh repairs
Vaginal Mesh Repair Prof. Aslam LGH Lahore 17

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19. Thank You
Vaginal Mesh Repair Prof. Aslam LGH Lahore 19