Perhaps as controversial as urogynecology is the debate surrounding optimal monitoring for the patient in labor.
In the early 1980s, for instance, there was the debate on which incontinence procedure generated the most favorable outcomes: the Raz procedure, the Burch procedure, or the Marshall-Marchetti-Krantz (MMK) procedure. In the 1990s, the controversy revolved around the question of whether abdominal or vaginal surgery provided the best results.
In the current decade, the ongoing debate is centered on the best materials to use during vaginal reconstructive surgery. In this issue, Lieschen Quiroz, MD, and Victoria Handa, MD, present an excellent review of the advantages and disadvantages of the currently available materials. Their comparison is based on reported success rates, complication rates, and recurrence rates. Clearly, the controversy in this field has led to the development of better products and improved patient outcomes.
Stem cell research remains one of the most controversial topics facing society today. Though not as provocative as using embryos as a source for stem cells, the idea of banking fetal cord blood for potential use in the future is fraught with debate. Kenneth Moise, MD, reviews many of the pertinent issues surrounding this subject: the realistic use of the cells now and in the future, public versus private banking and the costs involved in the process. Clearly we are in the infancy of this technology and it is unclear if society is ready to pay the price.
In conclusion, our Executive Editor, Paul Cerrato, provides an excellent article describing a cutting-edge technology that has the potential to enhance the detection of Rh disease. This technological advancement will allow for earlier and more accurate detection of an Rh-negative mother exposed to a fetus with Rh-positive blood. The technology described in the article is very impressive but the controversy may not be evident until the products are introduced to the public. If history is a predictor, this will only lead to better products for years to come.