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Experimental and clinical use of meshes in urogynecology.

The most frequent problem in urogynecology is a problem of pelvic support. Experimental results with the use of synthetic materials (meshes) were promising.  Although there is no an ideal synthetic material, low weight monofilament materials are the most acceptable for clinical use. The treatment of stress urinary incontinence is equally successful both with the transobturatory and retropubically placed slings, especially in cases with urethral hypermobility and “pure” stress incontinence. Treatment is simple, safe and durable. This is a gold standard of treatment now. Meshes were not highly successful in the treatment of all aspects of pelvic organ prolapse. Anatomical correction was satisfactory, but overall improvement in quality of life is not superior compared to the natural tissue repair. Reoperation rate is higher; complications are more serious, compared with the natural tissue repair. Use of meshes will be limited in the following years, only in special cases.