Phenotyping of isolated mesh associated pain secondary to continence mesh device insertion.

Introduction: Isolated Mesh associated Pain Syndrome (I-MAPS) is the most common complication of continence mesh devices. The pain mechanism involved remains unknown. The aim of this study is to characterise the phenotype of women with I-MAPS related to a single continence device and to determine the pain mechanisms involved. These findings are intended to support better understanding of the management of I-MAPS. Study design and methods: A cross-sectional study set within a quaternary-level mesh complications service. All women with I-MAPS related to a single continence device were included. Pain phenotype was determined using pain body-mapping, the Pain DETECT questionnaire (PDQ), and the Electronic Patient Assessment Questionnaire (e PAQ) to measure vagina and bladder pain. Quality of Life (QOL) and mental wellbeing were ascertained using the EuroQol group-5 Dimension (EQ5D) and WHO-5 wellbeing index. Results: Over 5-years, 280 women presented with I-MAPS. Subjects reported high levels of pre-existing pain-inducing conditions ( Conclusion: I-MAPS appears to be of neuropathic phenotype with evidence of mixed origin. Nociplastic features were identified including functional disability and reduced mood and QOL. These exemplify the multidimensional impact and burden of chronic pain.