International Urogynecology Journal

, Volume 22, Issue 1, pp 3–15

An International Urogynecological Association (IUGA) / International Continence Society (ICS) joint terminology and classification of the complications related directly to the insertion of prostheses (meshes, implants, tapes) & grafts in female pelvic floor surgery


    • University of New South Wales
    • St Vincent’s Clinic
  • Robert M. Freeman
    • Derriford Hospital
  • Steven E. Swift
    • Medical University of South Carolina
  • Michel Cosson
    • University Hospital
  • G. Willy Davila
    • Cleveland Clinic
  • Jan Deprest
    • University Hospital, UZ Leuven
  • Peter L. Dwyer
    • Mercy Hospital
  • Brigitte Fatton
    • University Hospital
  • Ervin Kocjancic
    • Department of UrologyUniversity of Illinois
  • Joseph Lee
    • Monash Hospital
  • Chris Maher
    • Wesley Hospital
  • Eckhard Petri
    • Urogynaecology DepartmentUniversity of Greifswald
  • Diaa E. Rizk
    • Ain Shams University
  • Peter K. Sand
    • Evanston Continence Centre
  • Gabriel N. Schaer
    • Kantonsspital
  • Ralph J. Webb
    • Norfolk & Norwich University Hospital
Special Contribution

DOI: 10.1007/s00192-010-1324-9

Cite this article as:
Haylen, B.T., Freeman, R.M., Swift, S.E. et al. Int Urogynecol J (2011) 22: 3. doi:10.1007/s00192-010-1324-9


Introduction and hypothesis

A terminology and standardized classification has yet to be developed for those complications arising directly from the insertion of synthetic (prostheses) and biological (grafts) materials in female pelvic floor surgery.


This report on the above terminology and classification combines the input of members of the Standardization and Terminology Committees of two International Organizations, the International Urogynecological Association (IUGA) and the International Continence Society (ICS) and a Joint IUGA/ICS Working Group on Complications Terminology, assisted at intervals by many expert external referees. An extensive process of 11 rounds of internal and external review took place with exhaustive examination of each aspect of the terminology and classification. Decision-making was by collective opinion (consensus).


A terminology and classification of complications related directly to the insertion of prostheses and grafts in female pelvic floor surgery has been developed, with the classification based on category (C), time (T) and site (S) classes and divisions, that should encompass all conceivable scenarios for describing insertion complications and healing abnormalities. The CTS code for each complication, involving three (or four) letters and three numerals, is likely to be very suitable for any surgical audit or registry, particularly one that is procedure-specific. Users of the classification have been assisted by case examples, colour charts and online aids (


A consensus-based terminology and classification report for prosthess and grafts complications in female pelvic floor surgery has been produced, aimed at being a significant aid to clinical practice and research.


Classification Complication Prosthesis Mesh Graft Female pelvic floor surgery

Copyright information

© The International Urogynecological Association 2010