Vaginale Deszensuschirurgie mit Gewebeersatz

Vaginal mesh surgery is both innovative and controversial. It has been proven that transvaginal access, reduction of mesh weight and inert coatings reduce mesh-specific complications so that patients profit from the use of vaginal meshes particularly in recurrent prolapse situations. Extended indications were therefore discussed and have already been clinically implemented. The critical discussion on vaginal mesh surgery means that more scientific data are being recruited, more expertise is being incorporated into operative implementation and affected patients are being more actively included in decision-making for or against the use of vaginal meshes. The sometimes too emotional assessment of vaginal mesh surgery occasionally diminishes a reasonable implementation and often leads to insufficiently indicated revision operations and complete mesh removal under conditions with questionable legal consequences. This article describes the current situation for prolapse surgery with tissue replacement and takes a critical stance from a scientific and especially clinical perspective.