Bilal Chughtai1, Art Sedrakyan2, Jialin Mao2, Karyn S Eilber3, Jennifer T Anger3, J Quentin Clemens4. 1. Department of Urology, Weill Cornell Medical College/New York Presbyterian Hospital, New York, NY. Electronic address: bic9008@med.cornell.edu. 2. Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY. 3. Department of Surgery, Division of Urology, Cedars-Sinai Medical Center, Los Angeles, CA. 4. Department of Urology, University of Michigan, Ann Arbor, MI.
Abstract
BACKGROUND: Polypropylene mesh has been used as a means of reinforcing weak tissues in women with pelvic organ prolapse and stress urinary incontinence. OBJECTIVE: We sought to investigate a potential link between the development of systemic/autoimmune disorders and synthetic polypropylene mesh repairs. STUDY DESIGN: New York State Department of Health Statewide Planning and Research Cooperative System data were utilized to conduct this retrospective cohort study. Adult women undergoing surgery for pelvic organ prolapse with vaginally implanted mesh from January 2008 through December 2009 in inpatient and ambulatory surgery settings in New York State were identified. Two separate control cohorts were created to compare outcomes, including a screening colonoscopy cohort and a vaginal hysterectomy cohort for benign gynecologic conditions (without pelvic organ prolapse repair or sling). Patients in the mesh cohort were individually matched to the control cohorts based on demographics, comorbidities, and procedure date. The development of systemic/autoimmune disease was determined before and after matching for 1-year, 2-year, 3-year, and entire follow-up (up to 6 years until December 2014) and differences between groups were evaluated. RESULTS: A total of 2102 patients underwent mesh-based pelvic organ prolapse surgery from January 2008 through December 2009. In the control cohorts, 37,298 patients underwent colonoscopy and 7338 underwent vaginal hysterectomy. When patients were matched based on demographics, comorbidities, and procedure time, mesh-based surgery was not associated with an increased risk of developing autoimmune disease at any of the evaluated time periods. CONCLUSION: Mesh-based vaginal surgery was not associated with the development of systemic/autoimmune diseases. These data refute claims against mesh as a cause of systemic disease.
BACKGROUND:Polypropylene mesh has been used as a means of reinforcing weak tissues in women with pelvic organ prolapse and stress urinary incontinence. OBJECTIVE: We sought to investigate a potential link between the development of systemic/autoimmune disorders and synthetic polypropylene mesh repairs. STUDY DESIGN: New York State Department of Health Statewide Planning and Research Cooperative System data were utilized to conduct this retrospective cohort study. Adult women undergoing surgery for pelvic organ prolapse with vaginally implanted mesh from January 2008 through December 2009 in inpatient and ambulatory surgery settings in New York State were identified. Two separate control cohorts were created to compare outcomes, including a screening colonoscopy cohort and a vaginal hysterectomy cohort for benign gynecologic conditions (without pelvic organ prolapse repair or sling). Patients in the mesh cohort were individually matched to the control cohorts based on demographics, comorbidities, and procedure date. The development of systemic/autoimmune disease was determined before and after matching for 1-year, 2-year, 3-year, and entire follow-up (up to 6 years until December 2014) and differences between groups were evaluated. RESULTS: A total of 2102 patients underwent mesh-based pelvic organ prolapse surgery from January 2008 through December 2009. In the control cohorts, 37,298 patients underwent colonoscopy and 7338 underwent vaginal hysterectomy. When patients were matched based on demographics, comorbidities, and procedure time, mesh-based surgery was not associated with an increased risk of developing autoimmune disease at any of the evaluated time periods. CONCLUSION: Mesh-based vaginal surgery was not associated with the development of systemic/autoimmune diseases. These data refute claims against mesh as a cause of systemic disease.
Authors: Kaitlyn Grando; Lauren K Nicastro; Sarah A Tursi; Jaime De Anda; Ernest Y Lee; Gerard C L Wong; Çağla Tükel Journal: Front Cell Infect Microbiol Date: 2022-05-11 Impact factor: 6.073
Authors: Elizabeth J Goodall; Rufus Cartwright; Emily C Stratta; Simon R Jackson; Natalia Price Journal: Int Urogynecol J Date: 2018-09-18 Impact factor: 2.894
Authors: Thais Regina de Mattos Lourenço; Vasilis Pergialiotis; Constantin M Durnea; Abdullatif Elfituri; Jorge Milhem Haddad; Cornelia Betschart; Gabriele Falconi; Christiana Campani Nygaard; Stergios K Doumouchtsis Journal: Int Urogynecol J Date: 2021-04-08 Impact factor: 2.894