Prolapse surgery: an update

PURPOSE OF REVIEW: The purpose of the review is to highlight the latest developments in the surgical treatment of pelvic organ prolapse. RECENT FINDINGS: Total vaginal mesh has been developed with the intent to improve the outcome of pelvic floor reconstructive surgery. Two interesting papers were published in 2006. At the short follow up available, the data appear interesting, although the rate of erosions is quite high. Two American teams reported their experience in robotic surgery for the management of sacrocolpopexy and hysterectomy. The published data on the use of the da Vinci system are interesting, although they need to be reproduced and improved in other centers. A randomized controlled trial suggests the efficacy of Burch colposuspension as an antiincontinence procedure in patients undergoing sacrocolpopexy for pelvic organ prolapse. SUMMARY: Total vaginal mesh and robotic surgery are major innovations in the field of urogynecology. Also, Burch colposuspension has proved to be an effective antiincontinence procedure in patients undergoing sacrocolpopexy for pelvic organ prolapse. Further studies are needed, however, with longer follow-up periods.