Mesh, graft, or standard repair for women having prolapse surgery

PROSPECT was the largest randomised study of the use of mesh or graft in transvaginal prolapse surgery to date. The investigators in this trial assessed augmentation of transvaginal prolapse surgery with synthetic absorbable or non-absorbable mesh (type 1 monofilament macroporous polypropylene) or biological grafts (porcine acellular collagen matrix, porcine small intestinal submucosa, or bovine dermal).
The findings from Glazener and colleagues' study support the limitations of prolapse repair surgery, with persistent symptoms or anatomical support loss in too many patients. In their study, the investigators noted that more than 80% of the participants had at least one residual, postoperative prolapse symptom.

Glazener, Cathryn MA et al. (2017). Mesh, graft, or standard repair for women having primary transvaginal anterior or posterior compartment prolapse surgery: two parallel-group, multicentre, randomised, controlled trials (PROSPECT).  The Lancet , 389(10067), 381-392.