Title |
The IUGA/ICS classification of synthetic mesh complications in female pelvic floor reconstructive surgery: a multicenter study
|
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Published in |
International Urogynecology Journal & Pelvic Floor Dysfunction, December 2015
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DOI | 10.1007/s00192-015-2913-4 |
Pubmed ID | |
Authors |
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 |
Abstract |
The objective was to report patterns of sling and transvaginal mesh-related complications using the IUGA/ICS classification of prosthesis-related complications. 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. 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). 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. |
Mendeley readers
Geographical breakdown
Country | Count | As % |
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United States | 1 | 2% |
Unknown | 42 | 98% |
Demographic breakdown
Readers by professional status | Count | As % |
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Researcher | 6 | 14% |
Student > Ph. D. Student | 5 | 12% |
Student > Doctoral Student | 5 | 12% |
Professor > Associate Professor | 5 | 12% |
Student > Master | 5 | 12% |
Other | 11 | 26% |
Unknown | 6 | 14% |
Readers by discipline | Count | As % |
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Medicine and Dentistry | 28 | 65% |
Engineering | 2 | 5% |
Computer Science | 1 | 2% |
Nursing and Health Professions | 1 | 2% |
Unknown | 11 | 26% |