Interobserver variability when employing the IUGA/ICS classification system for complications related to prostheses and grafts in female pelvic floor surgery

Gowda, Meghana; Kit, Laura Chang; Reynolds, W. Stuart; Wang, Li; Dmochowski, Roger R.; Kaufman, Melissa R.

doi:10.1007/s00192-013-2078-y

Cited by 8 publications

(3 citation statements)

References 12 publications

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“…This is not a surprising finding since only 14% of the reports in the medical literature describing complications related to prosthesis/graft in pelvic surgery utilize this system . Gowda et al found that this classification has poor inter‐observer reliability, highlighting its complex nature. Efforts should be directed toward developing an improved system to ensure a widespread application in clinical and research fields.…”

Section: Discussionmentioning

confidence: 99%

Trends in pelvic organ prolapse management in Latin America

Plata

Bravo‐Balado

Robledo

et al. 2017

Neurourology and Urodynamics

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Section: Discussionmentioning

confidence: 99%

Trends in pelvic organ prolapse management in Latin America

Plata

Bravo‐Balado

Robledo

et al. 2017

Neurourology and Urodynamics

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“…There has been a mixed reaction to the IUGA/ICS classification system in the literature. Some studies have also found difficulty assigning a code to patients while others have been able to classify all or most . The interobserver reliability of the CTS system is poor but may be improved with optimized instruction .…”

Section: Discussionmentioning

confidence: 99%

“…Some studies have also found difficulty assigning a code to patients while others have been able to classify all or most . The interobserver reliability of the CTS system is poor but may be improved with optimized instruction . Some studies have found good general applicability but recommend altering the system to include voiding dysfunction and de novo overactive bladder as there is currently no way to account for these common complications .…”

Section: Discussionmentioning

confidence: 99%

Clinical application of IUGA/ICS classification system for mesh erosion

Batalden

Weinstein

Foust-Wright

et al. 2015

Neurourology and Urodynamics

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Aims Our aim was to assess the usability of the IUGA/ICS classification system for mesh erosion in a tertiary clinical practice and to determine if assigned classification is associated with patient symptoms, treatment, and outcome. Methods We retrospectively identified women who had mesh erosion after prolapse or incontinence surgery. Each erosion was classified using the IUGA/ICS category time site (CTS) system. Associations between classification and presenting symptom (asymptomatic, pain, bleeding, voiding, or defecatory dysfunction, infection, prolapse), treatment type, and outcome were evaluated with chi-squared test, student’s t-test, and univariate logistic regression. Results We identified 74 subjects with mesh erosion; only 70% were classifiable. Asymptomatic patients (n = 19) (Category A) were more likely to be managed conservatively (P = 0.001). Symptomatic patients (n = 55) (Category B) were more likely to be managed surgically (P = 0.003). Other variables had no association with treatment. No variables were associated with outcome. Presenting symptom was associated with both treatment (P = 0.005) and outcome (P = 0.03). Asymptomatic subjects were more likely to have satisfactory outcome (P = 0.03). Urinary frequency and urgency were highly correlated with surgical management (P = 0.02). Conclusions One third of mesh erosions could not be retrospectively coded using the IUGA/ICS classification. The components of the system were not predictive of treatment nor outcome with exception of the Category A (asymptomatic) and Category B (symptomatic). Asymptomatic women with mesh erosion can be successfully managed with conservative measures. Use of a classification system may be enhanced if the system is simplified by limiting the number of variables to those associated with interventions and patient outcome.

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