The American College of Obstetricians and Gynecologists (ACOG) and the American Urogynecologic Society (AUGS) have jointly developed guidelines for the diagnosis and management of pelvic organ prolapse (POP) in women. Based on a review of information and current understanding of POP in women, ACOG/AUGS recommendations and conclusions (Level A) 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.
- Polypropylene mesh augmentation of anterior vaginal wall prolapse repair improves anatomic and some subjective outcomes but does not affect reoperation rates for recurrent prolapse and is associated with a higher rate of complications compared with native tissue vaginal prolapse repair.
The guidelines also offer additional recommendations and conclusions based on Level B and Level C evidence.
Pelvic organ prolapse. Practice bulletin No. 176. American College of Obstetricians and Gynecologists. Obstet Gynecol. 2017;129:e56–72.
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