A critical review of mesh kits for prolapse repairs

Demographic trends in the United States clearly indicate an aging population; therefore, a steady percentage of women with pelvic floor dysfunction suggests that ever-increasing numbers of women will seek treatment for conditions such as pelvic prolapse. Surgical techniques have rapidly evolved in recent years to include multiple proprietary kits that purport to facilitate repair using synthetic graft implants in minimally invasive fashion. Most of these products have entered the market so quickly that scientific literature lags behind with evidence to document safety and efficacy. We initially intended to examine recent publications on surgical kits for pelvic prolapse repair, but realized that, although numerous clinicians are collecting data and publishing sporadically, most information is now only available in abstract form. Therefore, this article focuses on the Apogee and Perigee systems (American Medical Systems, Minnetonka, MN), Avaulta (Bard Urological, Covington, GA), Gynecare Prolift (Ethicon, Somerville, NJ), and USS Posterior Intravaginal Slingplasty system (Tyco Healthcare, US Surgical, Norwalk, CT).