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Failure of Expectations in Vaginal Surgery: Lack of Appropriate Consent, Goals and Expectations of Surgery
Abstract
Introduction and background Vaginal surgery for the treatment of urinary stress incontinence (USI) and pelvic organ prolapse (POP) using a synthetic polypropylene mesh is going through a time of unprecedented turmoil and debate. This review focuses on vaginal surgery for vaginal prolapse and looks at the current scientific literature on issues surrounding surgery including consent and expectations.Safety and effectiveness of surgical options Synthetic mesh has been used both abdominally and vaginally to improve the effectiveness of POP surgery. The relatively high incidence of mesh complications particularly with vaginal surgery has lead to repeat surgery, disappointment and litigation in some women. The benefits and risks of the various POP procedures are reviewed including native tissue repair, uterine conservation and obliterative vaginal surgery.Conclusion Women with symptomatic pelvic organ prolapse and their doctors have many treatment options. The benefits and risks should be discussed as part of shared decision making.
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“This mismatch, and that between expectations and goals, may be influenced by inadequate counselling, poor ‘customer’ care, consideration of the impact of prolapse on body image, sexual function, and perhaps other indirect effects; those on a woman's anxiety, depression, and cognitive state [25, 26, 27, 28, 29].”
From How Can We Improve the Assessment and Indifferent Outcomes From Pelvic Organ Prolapse Management From Conservative and Surgical Therapies? ICI‐RS 2025 (2026) · cites this paper as [27]
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References 35 · Cited by 12
Metadata
- Authors
- Karmakar, D., & Dwyer, P. L.
- Affiliations
- Mercy Hospital for Women (AU)
- Corresponding author
- Karmakar, Debjyoti
- Venue
- Current Urology Reports
- Published
- 2016-10-22
- Volume
- 17
- Issue
- 12
- Pages
- 87-87
- ISSN
- 1527-2737 (ISSN-L)
- 1534-6285
- OpenAlex
- W2537567890
- Cited by
- 12
- References
- 35
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 1 · 2022: 1 · 2021: 2 · 2019: 2 · 2018: 4
- FWCI
- 0.32
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Current Urology Reports (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Urology › Pelvic floor disorders treatments
- Health Sciences › Medicine › Obstetrics and Gynecology › Uterine Myomas and Treatments
- Health Sciences › Medicine › Urology › Ureteral procedures and complications
- Keywords
- vaginal surgery, pelvic organ prolapse, stress urinary incontinence, synthetic mesh, mesh complications, informed consent, patient expectations, shared decision-making, native tissue repair, uterine conservation, reoperation, litigation
- MeSH terms
- Patient Reported Outcome Measures, Female, Humans, Informed Consent, Patient Care Planning, Patient Education as Topic, Physician-Patient Relations, Postoperative Complications, Surgical Mesh, Urinary Incontinence, Stress, Uterine Prolapse, Vagina, Pelvic Organ Prolapse
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- CoChat. (2026). Citation check: Failure of Expectations in Vaginal Surgery: Lack of Appropriate Consent, Goals and Expectations of Surgery. https://app.cochat.ai/papers/10.1007/s11934-016-0642-y
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- Karmakar, D., & Dwyer, P. L. (2016). Failure of Expectations in Vaginal Surgery: Lack of Appropriate Consent, Goals and Expectations of Surgery. Current Urology Reports. https://doi.org/10.1007/s11934-016-0642-y
