E-Posters-Mesh Erosion is Not a Dindo Grade 3 Complication

Mesh Erosion is Not a Dindo Grade 3 Complication - Joye K Lowman, MD, MPH

Pdf Summary

The purpose of the Dindo-Clavien surgical complication grading system is to classify postoperative complications and stratify surgical risk. However, this system has been incorrectly used to describe vaginal mesh erosion, inflating the perceived morbidity associated with it. This study aims to clarify the intended use of the classification system and demonstrate that it is not applicable to describing vaginal mesh erosion and its treatment. <br /><br />The Dindo-Clavien system grades complications based on the therapy required to treat them. In the initial system introduced in 1992 and revised in 2004, Grade 1 described minor events not needing therapy, while Grades 2 and above required interventions for potentially life-threatening complications. In the modified version, Grade 2b events, which previously required invasive procedures, are now listed as Grade 3, further divided into 3a and 3b depending on the need for general anesthesia. These Grade 3b complications are severe and require surgical intervention to save the patient's life or prevent severe morbidity/disability. <br /><br />However, vaginal mesh erosion is not a perioperative complication and does not reflect the severity or morbidity described by the examples provided for Grade 3b complications. The development and treatment of mesh erosion do not accurately reflect the risk or severity of the procedure in which the mesh was implanted. The incidence of mesh erosion also does not indicate an increased surgical risk. Therefore, classifying mesh erosion requiring surgical revision as a Grade 3 Dindo complication is inappropriate and misleading. <br /><br />Overall, using the Dindo system to describe vaginal mesh erosion and its treatment is not appropriate and has led to an inaccurate classification of the morbidity associated with it, as well as the procedures involved.

Keywords

Dindo-Clavien surgical complication grading system

postoperative complications

surgical risk

vaginal mesh erosion

morbidity

therapy

Grade 1

Grade 2

Grade 3

surgical intervention