Hindawi Publishing Corporation Obstetrics and Gynecology International Volume 2012, Article ID 672356, 4 pages doi:10.1155/2012/672356 Clinical Study Is Mesh Becoming More Popular? Dilemmas in Urogynecology: A National Survey Alexander Condrea,1, 2 Itamar Netzer,3 Shimon Ginath,1, 2 Joseph Eldor-Itskovitz,3 Abraham Golan,1, 2 and Lior Lowenstein3 1 Edith Wolfson Medical Center, 62 HaLohamim Street, P.O. Box 5, Holon 58100, Israel 2 Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel 3 Department of Obstetrics and Gynecology, Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Rambam Health Care Campus, 6 Ha’Aliya Street, P.O. Box 9602, Israel Correspondence should be addressed to Lior Lowenstein, lowensteinmd@gmail.com Received 14 July 2011; Revised 13 September 2011; Accepted 19 September 2011 Academic Editor: Kimberly Kenton Copyright © 2012 Alexander Condrea et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The use of vaginal mesh in pelvic organ prolapse (POP) repair surgery has become more common in recent years. The purpose of the current study was to evaluate the common practice of Israeli urogynecologists, and to determine whether surgical practice has changed over the last two years. Methods. In 2009 and again in 2011, a survey was mailed to all urogynecologists aﬃliated with an academic institute in Israel. The survey consisted of 7 Likert-scale items and 3 open questions; the latter inquired about preferred type of surgery in three clinical scenarios. Results. Of 22 practitioners, 15 responded to the survey. The number of urogynecologists who reported using vaginal mesh for the repair of primary POP increased from 47 to 67% from 2009 to 2011. The number who would not use vaginal mesh in POP repair of elderly patients dropped from 60 to 3%. Finally, for the treatment of a 35-year- old patient with stage III uterine prolapse who desired to preserve fertility, 13% recommended the used vaginal mesh in 2009 compared with 47% in 2011. Conclusion. A survey of practitioners shows that the use of vaginal mesh for the repair of primary and recurrent pelvic organ prolapse has become more common among Israeli urogynecologists. 1. Introduction The use of vaginal mesh in pelvic organ prolapse repair surgery has recently become more common [1]. A number of prolapse repair mesh devices have been designed by diﬀerent companies and marketed extensively as a minimally invasive approach to pelvic ﬂoor repair. A Cochrane Collaboration review entitled “Surgical management of pelvic organ prolapse in women,” and based on 3773 patients in 40 trials, was published in 2010 [2]. The authors concluded that abdominal sacral colpopexy is associated with a lower rate of recurrent vault prolapse (RR 0.23, 95% CI 0.07–0.77) and dyspareunia (RR 0.39, 95% CI 0.18–0.86) than vaginal sacrospinous colpopexy, though the latter was found to have a shorter operating time. The use of mesh or graft inlays at the time of anterior vaginal wall repair was found to reduce the risk of recurrent anterior wall prolapse. Standard anterior repair was associated with more anterior compartment failures on examination than was polypropylene mesh repair as an overlay (RR 2.14, 95% CI 1.23 to 3.74) or armed transobturator mesh (RR 3.55, 95% CI 2.29 to 5.51) [2]. However, due to the paucity of peer-reviewed manuscripts, the authors advised relating to this procedure with caution. Reliable long-term data on the eﬀect of vaginal mesh in pelvic organ prolapse surgery is particularly lacking. Subsequent to a metaanalysis of the use of vaginal mesh in pelvic organ prolapse repair surgery, the Society