Sacrocolpopexy using mesh for vaginal vault prolapse repair
This is an extract from the guidance. The complete guidance is available at guidance.nice.org.uk/ipg283
It replaces the previous guidance on mesh sacrocolpopexy for vaginal vault prolapse (Interventional Procedures Guidance no. 215, March 2007).
1.1 Current evidence on the safety and efficacy of sacrocolpopexy using mesh for vaginal vault prolapse repair appears adequate to support the use of this procedure provided that normal arrangements are in place for clinical governance and audit.
1.2 During the consent process, clinicians should ensure patients understand that there is a risk of recurrence of vaginal vault prolapse after any prolapse repair procedure, and that there is also a risk of complications, including mesh erosion (for example, into the vagina), and provide them with clear written information. In addition, use of NICE's information for patients ('Understanding NICE guidance') is recommended.
1.3 The procedure should only be carried out by surgeons specialising in the management of pelvic organ prolapse and female urinary incontinence.
1.4 Evidence on safety and efficacy outcomes is limited to 5 years. Evidence on outcomes beyond 5 years and on different types of mesh would be useful. Further research should include patientreported quality-of-life outcome measures using validated scales.