Recent advances in pelvic floor repair.

Stress urinary incontinence (SUI) and pelvic organ prolapse (POP) are conditions which result in significant physical, mental and social consequences for women worldwide. The high rates of recurrence reported with primary repair for POP led to the use of synthetic mesh to augment repairs in both primary and secondary cases following failed previous POP repair. The widely reported, unacceptably high rates of complications associated with the use of synthetic, transvaginal mesh in pelvic floor repair have severely limited the treatment options that surgeons can offer. This article summarises the recent advances in pelvic floor repair, such as improved quantification and modelling of the biomechanics of the pelvic floor and the developing technology within the field of tissue engineering for treatment of SUI/POP, including biomaterials and cell-based therapies. Finally, we will discuss the issues surrounding the commercial introduction of synthetic mesh for use within the pelvic floor and what lessons can be learned for the future as well as the current guidance surrounding treatment for SUI/POP.

Déclaration de conflit d'intérêts

Competing interests: EM has received a grant from the Urology Foundation to undertake an MD in “The use of patients’ own fat derived cells to stimulate regeneration of the pelvic floor”. CC is an author for Allergen; received a grant, did a Scientific Study/Trial and is a researcher, author, meeting participant, speaker and consultant/advisor for Astellas; is a consultant/advisor for Bayer Schering Pharma AH, Ferring, Galvani Bioelectronics (GSK), Pierre Fabre, Tari Biomedical, Urovant Sciences; also a consultant/advisor and has a patent for Symimetics; did a Scientific Study/Trial and is a researcher for Ipsen; and is a meeting participant and speaker for Pfizer. SM has no competing interests.No competing interests were disclosed.No competing interests were disclosed.No competing interests were disclosed.