The posterior compartment – whose domain is it?

In an interesting article published in this edition of SAJOG, Adam and co-workers look at the differences between gynaecologists and urologists with regard to management of the posterior pelvic compartment. Compared with urologists, gynaecologists saw more patients with disorders of the posterior compartment and performed more surgical procedures in this area. However, when it came to surgery, urologists inserted a mesh with sacrospinous ligament fixation much more frequently than gynaecologists (58% v. 17%). The findings reported in this article raise two questions: why do urologists use mesh so much more often, and is it ethically acceptable that urologists manage disorders of the posterior compartment?