Dietz Hans P
Aust N Z J Obstet Gynaecol. 2009 Aug;49(4):344-5. doi: 10.1111/j.1479-828X.2009.01034.x.
We are in the midst of an increasingly acrimonious discussion regarding the use of mesh in pelvic reconstructive surgery. Modern mesh kits, aggressively marketed by biotech companies, have become widespread. At times, they are used inappropriately, and significant complications such as pain syndromes and erosion are not uncommon. While conventional alternatives such as sacrospinous colpopexy and Burch colposuspension are not without their problems either, the discussion surrounding mesh use has a character never encountered before in urogynaecology. Many colleagues feel that the resolution of this conflict may be found in large randomised controlled trials such as the PROSPECT trial currently being planned in the UK. I feel that such a trial may well do more harm than good, unless certain precautions are taken. In this opinion piece I'll try and explain why.
我们正处于一场关于盆腔重建手术中使用网片的讨论日益激烈的阶段。现代网片套件由生物技术公司大力推广，已广泛使用。有时，它们被不恰当地使用，诸如疼痛综合征和侵蚀等严重并发症并不罕见。虽然传统的替代方法，如骶棘韧带阴道固定术和Burch阴道悬吊术也并非没有问题，但围绕网片使用的讨论具有泌尿妇科前所未有的特点。许多同事认为，解决这一冲突的方法可能在于大型随机对照试验，比如目前正在英国计划的PROSPECT试验。我认为，除非采取某些预防措施，这样的试验可能弊大于利。在这篇观点文章中，我将试着解释原因。
