Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Guideline Update on Pelvic Organ Prolapse

Obstet Gynecol; ePub 2017 Nov; Tulikangas, et al

The American College of Obstetricians and Gynecologists (ACOG) and the American Urogynecologic Society (AUGS) have issued updated clinical management guidelines that highlight recent systematic review evidence on the use of biologic and synthetic mesh grafts in the repair of anterior pelvic organ prolapse (POP). The joint document reviews information on the current understating of POP in women and outlines guidelines for diagnosis and management. Updated (Level A) recommendations include:

  • Uterosacral and sacrospinous ligament suspension for apical POP with native tissue are equally effective surgical treatments of POP, with comparable anatomic, functional, and adverse outcomes.
  • The use of synthetic mesh or biologic grafts in transvaginal repair of posterior vaginal wall prolapse does not improve outcomes.
  • Compared with native tissue anterior repair, polypropylene mesh augmentation of anterior vaginal wall prolapse repair improved anatomic and some subjective outcomes but is associated with increased morbidity.
Citation:

Pelvic organ prolapse. Practice Bulletin No. 185. American College of Obstetricians and Gynecologists. Obstet Gynecol. 2017;130:e234–50.

This Week's Must Reads

ACOG Discourages Direct-to-Consumer Genetic Testing, Obstet Gynecol; ePub 2017 Nov; ACOG

Interpregnancy Interval After Pregnancy Loss, Obstet Gynecol; ePub 2017 Nov 3; Sundermann, et al

Opioid Prescribing & Patient Use After Hysterectomy, Obstet Gynecol; ePub 2017 Nov 3; As-Sanie, et al

IUD Retention After Cesarean or Vaginal Delivery, Contraception; ePub 2017 Nov 8; Colwill, et al

Discontinuation of Oral HT & Sexual Activity, Menopause; ePub 2017 Nov 6; Gass, et al

Must Reads in Clinical Guidelines

ACOG Discourages Direct-to-Consumer Genetic Testing, Obstet Gynecol; ePub 2017 Nov; ACOG

ACOG Offers Recommendations for Vaginal Seeding , Obstet Gynecol; ePub 2017 Nov; ACOG, et al

Guidelines for LARC Initiation and Management, Obstet Gynecol; ePub 2017 Nov; ACOG, et al

Assessing Vaginal Birth After Cesarean Delivery, Obstet Gynecol; ePub 2017 Nov; ACOG, et al

Management of Bleeding in Late Preterm Period, Am J Obstet Gynecol; ePub 2017 Oct 25; Gyamfi-Bannerman