REPORT OF COMPLICATIONS IN PELVICFLOOR SURGERY WITH NATIVE TISSUE, USING INTERNATIONALUROGYNECOLOGICAL ASSOCIATION AND INTERNATIONAL CONTINENCE SOCIETY(IUGA/ICS) CLASSIFICATION SCALE. 10. 8 YEARS OF EXPERIENCE IN AUNIVERSITY HOSPITAL.
C. A. DIAZ1, C.BELTRAN 2, G. A. PARRA 3;
1Urogynecology& pelvic floor Unit of Hospital de San Jose, Fndn. Univ. ofHlth.Sci. ( FUCS), Bogota, Colombia, 2Hosp. de San Jose,Bogota, Colombia, 3SES Hospital de Caldas, Ginecology andobstetrics unit. Manizales, Caldas., Fndn. Univ. of Hlth.Sci. (FUCS), Bogota, Colombia.
Introduction: significantefforts have been made to define and put into practice various typesof procedures and surgical techniques that combine traditionalprocedures and new techniques using a range of materials for thesurgical repair of the pelvic floor. These efforts have led togreater knowledge today of the use of mesh and native tissue in orderto perform vaginal procedures, which are always tailored to the needsof each patient. Repair using native tissue is not exempt fromcomplications. The IUGA / ICS., addressed the issue and designed astandard classification of terminology,  based on three criteria:category (C), time (T) and site (S), this classification summarizes awide range of possible clinical scenarios. The symptoms and findingsare expressed in a CTS code. The C identifies exposure and relatedcomplications, if there was injury to the urinary tract,gastrointestinal and patient engagement. T the time of appearance ofthis and the S the site where it occurred, which can help facilitatethe implementation of a more uniform and reliable complications insurgery of the pelvic floor.
Objective: There areno studies using the IUGA / ICS classification to reportcomplications in surgery with native tissue  (NT), so we want tocontribute to its development using this classification. Experienceof 8 years in a university hospital.
Methods: Adescriptive, retrospective, continuous study was conducted. Wereviewed the medical records of the patients who underwent NT from2008 to 2015. The IUGA / ICS classification was applied.
Results:We included 651 patients with NT. The overall complication rate was11.82% (77/651); the complications were: category (C) 1, 2, and 3(Vaginal compromise): 16/651 (2.45%); C4 (urinary tract): 20/651(3%); C5 (rectal/bowel): 11/651 (1.68%), C6 (skin/musculoskeletal):5/651 (0.76%), C7 (patient compromise): 25/651 (3.8%). The mostfrequent were: haematoma of surgical site (HSS) in 2.3% (15/651),bladder injury in 2.1% (14/651) intestinal in 1.5% (10/651) andureteral in 0.61% (4/651) The most frequent time was T1(Intraoperative at 48 hours) in 53.2% (41/77) and the site was S3(adjacent viscera) in 42.8% (33/77).
Conclusions: This isthe first publication reporting complications in NT using theIUGA/ICS classification. The complications that occur in NT are notinfrequent but are lower in our hospital than with meshes (11.8 vs22.5%, respectively) but can be potentially serious: ureteral,bladder, intestinal lesions and (HSS) which requires additionalprocedures. Using this classification it is more accurate to comparethe complications of NT with those observed in mesh surgeries whenusing the same parameter.
References: 1. Int UrogynecolJ.2016;27(12):1905-11 2. Int Urogynecol J.2012;23(5):515-26