title: Is vaginal mesh a stimulus of autoimmune disease?
abstract: Polypropylene mesh has been used as a means of reinforcing weak tissues in women with pelvic organ prolapse and stress urinary incontinence.
  
  
  
  We sought to investigate a potential link between the development of systemic/autoimmune disorders and synthetic polypropylene mesh repairs.
  
  
  
  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.
  
  
  
  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.
  
  
  
  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.affiliation: Department of Urology, Weill Cornell Medical College/New York Presbyterian Hospital, New York, NY. Electronic address: bic9008@med.cornell.edu.
authors.forename: Bilal
authors.initials: B
authors.lastname: Chughtai
authors.affiliation: Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY.
authors.forename: Art
authors.initials: A
authors.lastname: Sedrakyan
authors.affiliation: Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY.
authors.forename: Jialin
authors.initials: J
authors.lastname: Mao
authors.affiliation: Department of Surgery, Division of Urology, Cedars-Sinai Medical Center, Los Angeles, CA.
authors.forename: Karyn S
authors.initials: KS
authors.lastname: Eilber
authors.affiliation: Department of Surgery, Division of Urology, Cedars-Sinai Medical Center, Los Angeles, CA.
authors.forename: Jennifer T
authors.initials: JT
authors.lastname: Anger
authors.affiliation: Department of Urology, University of Michigan, Ann Arbor, MI.
authors.forename: J Quentin
authors.initials: JQ
authors.lastname: Clemens
mesh_terms: D001327:Autoimmune Diseases / Q000453:epidemiology*; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D009518:New York / Q000453:epidemiology; D056887:Pelvic Organ Prolapse / Q000601:surgery; D011126:Polypropylenes; D012189:Retrospective Studies; D013526:Surgical Mesh
chemical_list: D011126:Polypropylenes
keywords: autoimmune disease; prolapse; vaginal mesh