Joint project of the International Continence Society
and the International Urogynecological Association
†
Native Tissue Calculator
Prosthesis/Graft Complication Classification Code:
Category:
1
-
Vaginal: no epithelial separation
Include prominence (e.g. due to wrinkling or folding), mesh fibre palpation or contraction (shrinkage)
2
-
Vaginal: smaller ≤ 1cm exposure
3
-
Vaginal: larger >1cm exposure (or any extrusion)
4
-
Urinary Tract
Compromise or perforation. Including prosthesis (graft) perforation, fistula and calculus
5
-
Rectum or Bowel
Compromise or perforation. Including prosthesis (graft) perforation and fistula
6
-
Skin and / or musculoskeletal
Complications including discharge pain lump or sinus tract formation
7
-
Patient compromise
Including hematoma or systemic compromise
Division:
blank
Please select a category
Pain:
Unspecified
a
-
Asymptomatic or no pain
b
-
Provoked pain only
(during vaginal examination)
c
-
Pain during sexual intercourse
d
-
Pain during physical activities
e
-
Spontaneous pain
Time:
T1
-
Intraoperative to 48 hours
T2
-
48 hours to 2 months
T3
-
2 months to 12 months
T4
-
over 12 months
Site:
S0
-
No site applicable
S1
-
Vaginal: area of suture line
S2
-
Vaginal: away from area of suture line
S3
-
Trochar passage (except intra-abdominal)
S4
-
Other skin or musculoskeletal site
S5
-
Intra-abdominal
Notes
Multiple complications may occur in the same patient. There may be early and late complications in the same patient. i.e. All complications to be listed. Tables of complications may often be procedure specific.
The highest final category for any single complication should be used if there is a change over time.
Urinary tract infections and functional issues (apart from 4B) have not been included.
Table 1: Terminology involved in the Classification
TERMS USED
DEFINITION
PROSTHESIS
A fabricated substitute to assist a damaged body part or to augment or stabilize a hypoplastic structure
A: Mesh
A (prosthetic) network fabric or structure
B: Implant
A surgically inserted or embedded (prosthetic) device
C: Tape (Sling)
A flat strip of synthetic material
GRAFT
Any tissue or organ for transplantation. This term will refer to biological materials inserted
A: Autologous Grafts
From the woman’s own tissues e.g. dura mater, rectus sheath or fascia lata
B: Allografts
From post-mortem tissue banks
C: Xenografts
From other species e.g. modified porcine dermis, porcine small intestine, bovine pericardium
TROCAR
Narrow prosthetic / graft insertion needle / device
COMPLICATION
A morbid process or event that occurs during the course of a surgery that is not an essential part of that surgery
CONTRACTION
Shrinkage or reduction in size
PROMINENCE
Parts that protrude beyond the surface (e.g. due to wrinkling or folding with no epithelial separation)
SEPARATION
Physically disconnected (e.g. vaginal epithelium)
EXPOSURE
A condition of displaying, revealing, exhibiting or making accessible e.g. vaginal mesh exposure.
EXTRUSION
Passage gradually out of a body structure or tissue
COMPROMISE
Bring into danger
PERFORATION
Abnormal opening into a hollow organ or viscus
DEHISCENCE
A bursting open or gaping along natural or sutured line
Reference:
IUGA/ICS Joint Terminology and Classification of Complications Related Directly to the Insertion of Prostheses (Meshes, Implants, Tapes) or Grafts In Female Pelvic Floor Surgery
Bernard T Haylen
*o
, Robert M Freeman
*^o
, Steven E Swift
*o
, Michel Cosson
o
, G Willy Davila
º
, Jan Deprest
o
, Peter L Dwyer
*o
, Brigitte Fatton
º
, Ervin Kocjancic
o
, Joseph Lee
*
, Chris Maher
º
, Eckhard Petri
*
, Diaa E Rizk
*
, Peter K Sand
*
, Gabriel N Schaer
*
, Ralph Webb
^o
Standardization and Terminology Committee, International Urogynecological Association (IUGA)
*
& International Continence Society (ICS)
^
; Joint IUGA/ICS Working Group on Complications Terminology
o
Publication:
This ICS-IUGA Joint Standardisation report is being published simultaneously in January 2011 with the permission of both publishers:
Neurourology and Urodynamics, Wiley-Liss Inc.
International Urogynecology Journal, Springer-Verlag London Ltd.