Follow-up of mesh complications using the IUGA/ICS category-time-site coding classification.

Area of Science:

• Urogynecology
• Surgical Innovation
• Medical Device Safety

Background:

• The International Urogynecological Association (IUGA) and International Continence Society (ICS) developed a standardized complication classification.
• This classification facilitates international comparison and understanding of surgical complications.
• The IUGA/ICS code was applied to analyze complications following mesh insertion in pelvic organ prolapse repair.

Purpose of the Study:

• To assess the utility of the IUGA/ICS complication classification system (CTS code) in analyzing mesh-related complications.
• To evaluate the incidence and types of complications after vaginal prolapse repair using trocar-guided polypropylene mesh.

Main Methods:

• A retrospective study included 107 patients undergoing vaginal prolapse repair with polypropylene mesh (2006-2010).
• Complications were assessed at secondary follow-up using the IUGA/ICS Category (C), Timing (T), and Site (S) classification (CTS code).
• Data analysis focused on complication types, timing, location, and patient outcomes.

Main Results:

• Of 84 patients with follow-up (median 36 months), 43 complications were coded in 39 patients.
• Perioperative complications included hemorrhage and bladder perforation (6%).
• Mesh exposure (12%) and mesh wrinkling/shrinkage (36%) were noted at follow-up, with 8 women experiencing daily complaints or dyspareunia. 82% reported significant improvement.

Conclusions:

• The IUGA/ICS CTS code is a useful tool for describing mesh complications after prolapse surgery.
• The study recommends using the CTS code at follow-up consultations (minimum 2 years post-surgery) for better insights into complication occurrence.
• Continued application of this classification can enhance knowledge and management of mesh-related adverse events.