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Randomized trials comparing native-tissue prolapse repair with transvaginal mesh demonstrate that mesh can improve anatomic support in some compartments but may add complications including mesh exposure and reoperation. Longer-term follow-up has reinforced the need to weigh anatomical durability against device-related risks and patient-reported outcomes. For urogynecologists, the decision should be individualized according to the compartment involved, recurrence risk, previous surgery, sexual function and the patient's tolerance for mesh-related complications. The evidence does not support a blanket rule that mesh is either better or worse in every prolapse case. Instead, it highlights the importance of choosing the right procedure for the right anatomy and discussing realistic expectations before surgery.
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Randomized trials comparing native-tissue prolapse repair with transvaginal mesh demonstrate that mesh can improve anatomic support in some compartments but may add complications including mesh exposure and reoperation. Longer-term follow-up has reinforced the need to weigh anatomical durability against device-related risks and patient-reported outcomes. For urogynecologists, the decision should be individualized according to the compartment involved, recurrence risk, previous surgery, sexual function and the patient's tolerance for mesh-related complications. The evidence does not support a blanket rule that mesh is either better or worse in every prolapse case. Instead, it highlights the importance of choosing the right procedure for the right anatomy and discussing realistic expectations before surgery.
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