Trends in Urogynecology-Transvaginal Mesh Surgery in Germany.

Abstract

<h4>Background</h4>Pelvic organ prolapse constitutes a prevalent condition associated with a considerable impact on the quality of life. The utilization of transvaginal mesh surgery for managing POP has been a subject of extensive debate. Globally, trends in TVM surgery experienced significant shifts subsequent to warnings issued by the FDA.<h4>Methods</h4>This study aims to explore temporal patterns in transvaginal mesh surgery in the German healthcare system. A comprehensive analysis was conducted on in-patient data from the German Federal Statistical Office spanning 2006 to 2021. A total of 1,150,811 operations, each associated with specific codes, were incorporated into the study. Linear regression analysis was employed to delineate discernible trends.<h4>Results</h4>The trends in transvaginal mesh surgery within the anterior compartment exhibited relative stability (<i>p</i> = 0.147); however, a significant decline was noted in all other compartments (posterior: <i>p</i> < 0.001, enterocele surgery: <i>p</i> < 0.001). A subtle increasing trend was observed for uterine-preserving transvaginal mesh surgery (<i>p</i> = 0.045).<h4>Conclusion</h4>Surgical trends over the specified timeframe demonstrate how POP management has evolved globally. Notably, despite observed fluctuations, transvaginal mesh surgery remains a viable option, particularly for specific cases with a high risk of relapse and contraindications to alternative surgical approaches.