Clinical Report: Characterization of Phenotypes in Isolated Mesh-Related Pain

Overview

This study characterizes the pain phenotypes in women experiencing Isolated Mesh Associated Pain Syndrome (I-MAPS) following continence device insertion. It identifies a predominance of neuropathic pain and highlights the significant impact on quality of life and mental well-being.

Background

Isolated Mesh Associated Pain Syndrome (I-MAPS) is the most common complication following the insertion of continence mesh devices, with chronic pain being a significant concern for affected women. Understanding the pain mechanisms and phenotypes associated with I-MAPS is crucial for developing effective management strategies. The study aims to elucidate these aspects to improve patient care and outcomes.

Data Highlights

Key Findings

• I-MAPS is primarily characterized by neuropathic pain, with 55% of patients exhibiting this phenotype.
• 52% of patients reported pre-existing pain conditions prior to mesh insertion.
• Trans-obturator devices were associated with a higher mean PDQ score compared to retropubic devices (20 vs. 17).
• Patients reported moderate impacts on daily activities and significant levels of anxiety and depression.
• Quality of life and mental well-being scores were notably low, indicating a multidimensional burden of chronic pain.

Clinical Implications

Clinicians should consider the neuropathic nature of pain in patients with I-MAPS when developing treatment plans. A multidisciplinary approach may be beneficial in addressing the complex needs of these patients, particularly in managing pain and improving quality of life.

Conclusion

The characterization of pain phenotypes in I-MAPS reveals a significant prevalence of neuropathic pain and highlights the need for targeted management strategies to address the associated functional and psychological burdens.

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8. https://d56bochluxqnz.cloudfront.net/documents/full-guideline/EAU-Guidelines-on-Non-neurogenic-Female-LUTS-2025.pdf
9. 5-Year Longitudinal Follow-up after Retropubic and Transobturator Midurethral Slings - PMC
10. ICS-EUS 2025 Abstract #516 Phenotyping of Mesh Associated Pain Syndrome (MAPS) in continence mesh devices