To address evidence gaps on the management of complications related to mesh in pelvic floor surgery, we created an evidence-based algorithm that includes defining evidence gaps. We utilized the Delphi method within a panel of surgeons treating mesh complications to define a treatment strategy. The first round provided a list of clinically based postulates that informed a review expanding postulates to recommendations and included grading of the quality of evidence. A second round informed the final algorithm. While the quality of the available evidence is low, it provides a framework for planning diagnosis and management of mesh-related complications.
Tweetable abstract: Removal of mesh must balance resolution of complications with the risk of removal and recurrence of pelvic floor symptoms.
Keywords: Mesh complications; mesh exposure; pelvic pain; sexual dysfunction; transvaginal mesh.
© 2018 Royal College of Obstetricians and Gynaecologists.