title: Hernia repair with polypropylene mesh is not associated with an increased risk of autoimmune disease in adult men.
abstract: Synthetic mesh for herniorrhaphy has been placed under critical observation regarding the potential association of mesh placement and the subsequent development of autoimmune diseases. We sought to evaluate whether there is a link between synthetic polypropylene mesh repairs and the subsequent development of systemic/autoimmune disorders (SAID).
  
  
  
  Adult men undergoing hernia repair with mesh between January 2008 and December 2009 in New York State were identified using International Classification of Diseases, Ninth Revision, Modification procedure codes and Current Procedural Terminology Coding System, Fourth Edition codes. A control cohort of men undergoing colonoscopy was created with whom to compare outcomes.
  
  
  
  A total of 29,712 patients underwent hernia repair between January 2008 and December 2009. In the control cohort, 79,265 patients underwent colonoscopy. During the entire follow-up, 475 patients undergoing hernia repair and 1305 patients in the control cohort were diagnosed with autoimmune disease. When patients were matched based on demographics, comorbidities and procedure date, hernia repair was not associated with an increased risk of developing autoimmune disease over the entire follow-up time period. 1.6% of those in the hernia group vs. 1.7% of those in the colonoscopy group developed SAID [risk ratio (95% CI): hernia vs. colonoscopy 0.93(0.79-1.09)]. No association between mesh surgery and increased risks of SAID was found at any of the specified time points (6 months, 1 year, and 2-year follow-up).
  
  
  
  Mesh-based hernia repair was not associated with the development of autoimmune diseases compared to those undergoing routine screening colonoscopy.
authors.affiliation: Department of Urology, Weill Cornell Medicine/New York-Presbyterian Hospital, New York, 425 East 61st Street, 12th Floor, New York, 10065, USA. bic9008@med.cornell.edu.
authors.forename: B
authors.initials: B
authors.lastname: Chughtai
authors.affiliation: Department of Urology, Weill Cornell Medicine/New York-Presbyterian Hospital, New York, 425 East 61st Street, 12th Floor, New York, 10065, USA.
authors.forename: D
authors.initials: D
authors.lastname: Thomas
authors.affiliation: Department of Healthcare Policy and Research, Weill Cornell Medicine/New York-Presbyterian, New York, New York, 10065, USA.
authors.forename: J
authors.initials: J
authors.lastname: Mao
authors.affiliation: Department of Urology, Cedars-Sinai Medical Center, Beverly Hills, CA, 90211, USA.
authors.forename: K
authors.initials: K
authors.lastname: Eilber
authors.affiliation: Department of Urology, Cedars-Sinai Medical Center, Beverly Hills, CA, 90211, USA.
authors.forename: J
authors.initials: J
authors.lastname: Anger
authors.affiliation: Department of Urology, The University of Michigan Medical Center, Ann Arbor, MI, 48109, USA.
authors.forename: J Q
authors.initials: JQ
authors.lastname: Clemens
authors.affiliation: Department of Healthcare Policy and Research, Weill Cornell Medicine/New York-Presbyterian, New York, New York, 10065, USA.
authors.forename: A
authors.initials: A
authors.lastname: Sedrakyan
mesh_terms: D000328:Adult; D000368:Aged; D001327:Autoimmune Diseases / Q000209:etiology*; D015331:Cohort Studies; D059685:Herniorrhaphy / Q000295:instrumentation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011126:Polypropylenes / Q000276:immunology*; D012008:Recurrence; D012189:Retrospective Studies; D012306:Risk; D013526:Surgical Mesh / Q000009:adverse effects*
chemical_list: D011126:Polypropylenes
keywords: Autoimmune disease; Hernia; Herniorrhaphy; Mesh; Polypropylene; Synthetic