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abstract

51 - REPORT OF COMPLICATIONS WITH VAGINAL POLYPROPYLENE MESH FOR PELVIC ORGAN PROLAPSE REPAIR, USING INTERNATIONAL UROGYNECOLOGICAL ASSOCIATION AND INTERNATIONAL CONTINENCE SOCIETY (IUGA/ICS) CLASSIFICATION SCALE. 10 YEARS OF EXPERIENCE IN A UNIVERSITY HO

051

REPORT OF COMPLICATIONS WITH VAGINALPOLYPROPYLENE MESH FOR PELVIC ORGAN PROLAPSE REPAIR, USINGINTERNATIONAL UROGYNECOLOGICAL ASSOCIATION AND INTERNATIONALCONTINENCE SOCIETY (IUGA/ICS) CLASSIFICATION SCALE. 10 YEARS OFEXPERIENCE IN A UNIVERSITY HOSPITAL.

C. A. DIAZ1, C.BELTRAN 2, G. 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 Hosp. de caldas, manizales,Colombia.

Introduction: The use ofprosthetic mesh has increased considerably in the urogynecologicalsurgeries, this increasing the number of possible complicationsassociated with their use. In order to unify the criteria forreporting complications related to the placement of mesh prosthesisin surgery of the pelvic floor, the IUGA / ICS., addressed the issueand designed a standard classification of terminology, [1]
Objective:Few studies use the IUGA/ICS classification for reportingcomplications. We want to contribute to their development using thisclassification with the vaginal polypropylene mesh (VPM) in patientswith genital prolapse surgery. 10 years experience in a universityhospital.
Methods: A descriptive, retrospective, continuousstudy was performed. Clinical records were reviewed for those who hadVPM for prolapse repair from 2004 to 2015. The IUGA/ICS scale forcomplications was applied. Similar studies were reviewed in theliterature and compared with ours.
Results: 275 patientswere included. The commercial meshes used were: PolypropyleneMulti-Anchor (PMA) 38.9% (107/275), Tension Free Mesh (TFM) 25.4%(70/275) and 35,6% (98/275) Trocar Less (TL) meshes. The overallcomplication rate was 22.5% (62/275) The exposure rate was 13.45%(37/275), being asymptomatic by 50%. The highest complication ratewas with PMA/TFM 27.1% (48/177) Vs TL 14.2% (14/98). Damages ofrectum 1,09% (3/275) bladder 0,72% (2/275) and vascular 0,72% (2/275)The highest percentage of complications was PMA 45.1% (28/62).Exposure rate of PMA/TFM was 17.5% (31/177) and TL 7.1% (7/98). Mostfrequent time of onset: T3 (2 months to 12 months) 40.3% (25/62) andthe site of appearance S1 (suture line) 69.3% (43/62).
Conclusions:There is a higher complication rate with PMA/TFM meshes. Exposure isthe main complication, being 10.4% lower in TL meshes. Of theasymptomatic, few of them needs additional surgical procedures.Bladder, vascular and rectal are infrequent, but morbid. Our studycoincides with similar findings in the literature.
References:

  1. IntUrogynecol J.2010;22(1):3-15. 2. Int UrogynecolJ.2015;27(6):933-938. 3. Female Pelvic Med ReconstrSurg.2013;19(6):333-8. 4. Int Urogynecol J.2013; 25(1):109-116. IntUrogynecol J.2011; 22(11):1429-1435.