2013年 · 第48卷第01期

In the new year, there should be new goals and new achievements.

In recent 10 years, with the development of modern pelvic floor theory, the improvement of surgical instruments and the invention and application of repair materials, pelvic floor repair and reconstruction surgery have made breakthrough progress. Based on the shortcomings of high recurrence rate of traditional surgery, and drawing on the successful experience of surgical hernia repair and the application of sling in the treatment of stress urinary incontinence, the application of transvaginal mesh implantation to treat pelvic organ prolapse (POP) came into being since 2004, and the number of cases of POP treated with finished pelvic floor repair kits increased rapidly. According to the U.S. Food and Drug Administration (FDA), at least 100,000 POP patients in the United States underwent pelvic floor reconstruction surgery with mesh in 2010, of which about 75,000 were completed by vaginal operation. The use of finished mesh kits in China is also increasingly common. Compared with pelvic floor reconstruction with autologous tissue fascia, its main advantages are that it can simplify the operation to the maximum extent, correct the central and lateral defects of pelvic floor at the same time, realize the standardization and standardization of surgery, and bring great convenience to clinical work. Grade A evidence shows that transvaginal anterior wall mesh implantation can reduce anatomical recurrence rate^{[1,2,3,4,5,6,7,8,9,10]}。 However, this kind of new surgery itself is still at a "young" stage, and there is a lack of high-level evidence-based medical evidence to comprehensively evaluate its safety and effectiveness. In 2008 and 2011, the US FDA issued two safety warnings on complications caused by transvaginal mesh implantation^[11]The delisting of some POP mesh kits has aroused widespread concern from gynecologists at home and abroad. The Gynecological Pelvic Floor Group of the Obstetrics and Gynecology Branch of the Chinese Medical Association held a symposium on this, conducted extensive and in-depth discussions in combination with China's national conditions, and reached the following consensus for clinical practice reference of colleagues in obstetrics and gynecology.