I have noticed this for vulvar mechanics. But I would think they would understand the biomechanics of the vagina though, due to historic interest in the vagina as important for penetrative intercourse and reproduction.

I can’t see what systemic problem could be going on with these mesh surgeries. It looks like maybe risky surgery was recommended in many cases where not needed? Is this what went on? Financial incentives can factor into why doctors would operate when not necessary.

I think maybe what most problems come down to is that 4 years of residency is inadequate to do all things that OB/GYNs are doing. I think OB/GYN primarily attracts people who just really want to deliver babies. If you look at ACGME application for accreditation, minimum procedure numbers are only required for a few procedures. OB and GYN should be separate, and they should undergo more surgery training. But this would likely be very difficult to change.

The thing ACGME does that is evil is tell ambulatory surgery providers that OB/GYNs are qualified to do labiaplasties and clitoral hood reductions when they are not trained to do these and do not learn the anatomy. The 2018 application for accreditation was updated to include “simple vulvectomy” (instead of just “radical vulvectomy” — where they remove everything), but they remove tissue based on the location of the malignancy and do not take detailed neurovascular anatomy into account.