Surgery

Mesh vs native tissue repair: what does the evidence say?

The word 'mesh' now frightens many women — with good reason. Here is what has changed and what modern practice actually looks like.

Op. Dr. Berra Önsoy — Consultant Obstetrician & Gynaecologist
Medically written & reviewed by
Op. Dr. Berra Önsoy · Consultant Obstetrician & Gynaecologist
Istanbul, Turkey · 29 years of clinical practice · 8 min read · Consults in English & Turkish

Istanbul University Cerrahpaşa (English) MD, 1997. Ob-Gyn residency at Taksim Training & Research Hospital (2001). Private practice in Istanbul focused on endometriosis, myoma surgery, high-risk pregnancy and aesthetic gynaecology.

Clinical focus
  • Endometriosis surgery
  • Myoma (fibroid) surgery
  • High-risk pregnancy
  • Aesthetic gynaecology
  • HPV & colposcopy
Last medically reviewed: 15 January 2026View full clinical credentials·Verify on:drberraonsoy.cominstagram.com
Key takeaways
  • Vaginal mesh for prolapse is no longer used routinely.
  • Native-tissue repair is the modern first choice.
  • Abdominal laparoscopic mesh (sacrocolpopexy/hysteropexy) is a different, well-established operation.

Why mesh became controversial

In the 2000s, transvaginal mesh kits were widely used for prolapse repair and stress incontinence surgery. Some of these products caused serious, lasting harm to women — chronic pain, mesh erosion into the vagina or bladder, and repeated revision surgery. The UK Cumberlege review (First Do No Harm, 2020) recommended a pause on the use of vaginal mesh for prolapse; that pause remains in place on the NHS.

What modern reconstructive surgery uses

The vast majority of primary prolapse repairs today are native-tissue operations — the surgeon reconstructs the pelvic floor using the patient's own connective tissue and ligaments. No mesh is placed in the vagina.

A thin, biologically integrated tape may still be used in laparoscopic sacrocolpopexy or sacrohysteropexy, where it is placed abdominally between the vaginal apex and the sacrum. This is a fundamentally different application, with a well-documented long-term safety profile.

Which is right for you?

For most primary prolapse repairs, native-tissue reconstruction is the first choice. Sacrohysteropexy or sacrocolpopexy may be discussed for recurrent prolapse, for younger patients with a high physical activity level, or when the apex needs strong long-term support.

For UK patients

British women rightly ask hard questions about mesh. A good surgeon welcomes those questions and explains, in plain language, exactly what material would be used, where it would be placed, and what the alternatives are.

Frequently asked questions

Do you still use vaginal mesh?

For prolapse repair, no. Native-tissue reconstruction is the default.

Is abdominal mesh safe?

Laparoscopic sacrocolpopexy has one of the longest and best safety records in reconstructive gynaecology.

What about mesh for stress incontinence?

The mid-urethral tape is a separate product with a separate evidence base; it is discussed only when non-surgical options have failed.

Could a doctor-led plan help you?

A 30-minute video consultation with Dr Berra Önsoy — reviewing your symptoms, any UK imaging or referral notes, and giving you a clear, personalised next step. Suitable for women considering treatment from anywhere in the UK.

Request a video consultation

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