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International Urogynecology Journal

, Volume 27, Issue 6, pp 933–938 | Cite as

The IUGA/ICS classification of synthetic mesh complications in female pelvic floor reconstructive surgery: a multicenter study

  • John R. Miklos
  • Orawee Chinthakanan
  • Robert D. Moore
  • Gretchen K. Mitchell
  • Sheena Favors
  • Deborah R. Karp
  • Gina M. Northington
  • Gladys M. Nogueiras
  • G. Willy Davila
Original Article

Abstract

Introduction and hypothesis

The objective was to report patterns of sling and transvaginal mesh-related complications using the IUGA/ICS classification of prosthesis-related complications.

Methods

This was a retrospective chart review of all patients who underwent surgical removal of sling, transvaginal mesh, and sacrocolpopexy for mesh-related complications from 2011 to 2013 at three tertiary referral centers. The International Urogynecological Association (IUGA)/International Continence Society (ICS) classification system was utilized.

Results

We identified 445 patients with mesh complications, 506 pieces of synthetic mesh were removed, and 587 prostheses-related complications were classified. 3.7 % of patients had viscus organ penetration or vaginal exposure as their presenting chief complaint and 59.7 % were classified as not having any vaginal epithelial separation or category 1. The most common category was spontaneous pain (1Be: 32.5 %) followed by dyspareunia (1Bc: 14.7 %). The sling group was 20 % more likely to have pain compared with the pelvic organ prolapse (POP) mesh group (OR 1.2, 95 % CI 0.8–1.6). The most commonly affected site (S2) was away from the suture line (49 %). Compared with the sling group, the POP group had a higher rate of mesh exposure, which mostly occurred at the suture line area. The majority of patients presented with mesh-related complications more than 1 year post-insertion (T4; average 3.68 ± 2.47 years).

Conclusion

Surgeons should be aware that patients with vaginal mesh complications routinely exhibit complications more than 1 year after the implantation with pain as the most common presenting symptom.

Keyword

Mesh complication IUGA/ICS classification Sling complication Transvaginal mesh Mesh removal Mesh complication classification 

Notes

Compliance with ethical standards

Conflicts of interest

None.

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Copyright information

© The International Urogynecological Association 2015

Authors and Affiliations

  • John R. Miklos
    • 1
  • Orawee Chinthakanan
    • 1
    • 2
  • Robert D. Moore
    • 1
  • Gretchen K. Mitchell
    • 1
  • Sheena Favors
    • 1
  • Deborah R. Karp
    • 3
  • Gina M. Northington
    • 3
  • Gladys M. Nogueiras
    • 4
  • G. Willy Davila
    • 4
  1. 1.International Urogynecology AssociatesAtlanta, GA and Beverly HillsUSA
  2. 2.Department of Obstetrics and Gynecology, Faculty of MedicineChiang Mai UniversityChiang MaiThailand
  3. 3.Division of Female Pelvic Medicine & Reconstructive Surgery, Department of Gynecology and ObstetricsEmory UniversityAtlantaUSA
  4. 4.Cleveland Clinic FloridaWestonUSA

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