[Complications associated with plastic meshes and slings. A situation like in the US?]

New surgical strategies have rarely been accepted so rapidly in clinical routine worldwide, without available prospective studies proving safety and efficacy. After the success of midurethral slings, having been implanted in millions of patients, alloplastic meshes are available for the treatment of prolapse with new, so far unknown complications in relevant frequency. In the USA with their own medicolegal system, there have been a flood of litigations (> 60,000 in 2014), with compensations of > USD 10 million in individual cases. Even though medical strategies and surgical skills might be different in Germany this development should encourage strict indications and centralization in pelvic floor centers.