Management of complications arising from the use of mesh for stress urinary incontinence—International Urogynecology Association Research and Development Committee opinion
Introduction and hypothesis
Management of pain or mesh exposure complications after stress incontinence surgery has become a new issue over the last 20 years with the introduction of mesh techniques to treat stress incontinence. There is much debate regarding the incidence of complications and how best to treat them.
A working subcommittee from the International Urogynecology Association (IUGA) Research and Development (R&D) Committee was formed. An initial document was drafted based on a literature review. The review focused on complications of vaginal mesh inserted for stress incontinence. After evaluation by the entire IUGA R&D Committee revisions were made. The final document represents the IUGA R&D Committee Opinion.
The R&D Committee Opinion reviews the literature on the management of complications arising from the use of mesh for stress urinary incontinence. The review concentrated on the assessment and treatment of pain and exposure.
Complications after surgery for stress incontinence using mesh may not be common occurrences for individual surgeons. Complications may be difficult to manage and outcomes are variable. Specialist centres and a multidisciplinary approach may optimise treatment and reporting of outcomes.
KeywordsMesh Mideurethral sling Complication Stress incontinence
Compliance with ethical standards
Conflicts of interest
- 1.Morling JR, McAllister DA, Agur W, Fischbacher CM, Glazener CM, Guerrero K, et al. Adverse events after first, single, mesh and non-mesh surgical procedures for stress urinary incontinence and pelvic organ prolapse in Scotland, 1997–2016: a population-based cohort study. Lancet. 2017;389:629–40.CrossRefPubMedGoogle Scholar
- 3.Keltie K, Elneil S, Monga A, Patrick H, Powell J, Campbell B, et al. Complications following vaginal mesh procedures for stress urinary incontinence: an 8 year study of 92,246 women. Sci Rep. 2017;20(7):2015.Google Scholar
- 4.England NHS. Mesh oversight group report. Leeds: NHS England. 2017. https://www.england.nhs.uk/publication/mesh-oversight-group-report.
- 7.Barski D, Deng DY. Management of Mesh Complications after SUI and POP repair: review and analysis of the current literature. Biomed Res Int. 2015:831285. https://doi.org/10.1155/2015/831285.
- 13.ACOG Committee on Gynecologic practice, American urogynecologic society. Management of mesh and graft complications in gynecologic surgery. Committee opinion no 694. April 2017.Google Scholar
- 17.Haylen BT, Freeman RM, Swift SE, Cosson M, Davila GW, Deprest J, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint terminology and classification of the complications related directly to the insertion of prostheses (meshes, implants, tapes); grafts in female pelvic floor surgery. Int Urogynecol J. 2011;22(1):3–15.CrossRefPubMedGoogle Scholar
- 35.Goodall EJ, Cartwright R, Stratta EC, Jackson SR, Price N. Outcomes after laparoscopic removal of retropubic midurethral slings for chronic pai. Iny Urogynecol J 2018. https://doi.org/10.1007/s00192-018-3756-6.
- 39.Saidan D, Tyagi V, Granitsiotis V, Guerrero K. Outcomes following urinary tract midurethral mesh complications; UKCS-PFS annual meeting, 2018).Google Scholar