Transvaginal mesh repair of anterior or posterior vaginal wall prolapse

2.1 Vaginal wall prolapse is a protrusion of 1 or more pelvic organs (such as the bladder or the rectum) through the vaginal fascia. The vaginal wall then moves from its normal position (prolapses), into or outside the vagina. Vaginal wall prolapse can affect a woman's quality of life because of its local physical effects (pressure, bulging, heaviness or discomfort). It can also affect urinary, bowel or sexual function. There are different types of vaginal wall prolapse depending on the organs and sites involved. These include anterior vaginal wall prolapse (including prolapse of the urethra [urethrocele] or bladder [cystocele]) and posterior vaginal wall prolapse (including prolapse of the rectum [rectocele] or small bowel [enterocele]). A woman can present with prolapse of 1 or both of these sites.

2.2 Current treatment options for vaginal wall prolapse include pelvic floor muscle training, use of mechanical devices (ring or shelf pessaries) and surgery, including anterior or posterior colporrhaphy and site-specific defect repair such as paravaginal repair.

2.3 The aims of using mesh to repair vaginal wall prolapse are to add extra support and to reduce the risk of recurrence, particularly for women with recurrent prolapse or with congenital connective tissue disorders (such as Ehlers–Danlos syndrome or Marfan's syndrome).