Challenging the myth: Transvaginal mesh is not associated with carcinogenesis

We sought to determine if there was a potential link between synthetic polypropylene mesh implantation for transvaginal pelvic organ prolapse (POP) and stress urinary incontinence (SUI) and carcinogenesis using statewide administrative data.

Adult women undergoing transvaginal surgery for POP or SUI) with mesh between January 2008 and December 2009 in New York State were identified using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) procedure codes and Current Procedural Terminology Coding System, Fourth Edition (CPT-4) codes. Patients in the mesh cohort were individually matched to two control cohorts based on comorbidities and procedure date. Carcinogenesis was determined before and after matching at one year, two years, three years, and during entire follow-up time.

2,229 patients undergoing mesh based POP surgery and 10,401 patients undergoing sling surgery for SUI between January 2008 and December 2009 were included in the study. Mean follow up was six years (range: 5-7 years). Exact matching between mesh and control cohorts 1,870 (POP mesh to Cholecystectomy 1:2), 1,278 (POP mesh to Hysterectomy 1:1), 7,986 (Sling to Cholecystectomy 1:1) and 3,810 (Sling to Hysterectomy 1:1) pairs. Transvaginal mesh implantation was not associated with an increased risk of developing a cancer diagnosis (both pelvic/ local cancers or any cancer, respectively) at one year and during the entire follow up of up to seven years.

Transvaginal surgery with implantation of mesh was not associated with the development of malignancy at mean follow-up of six-years.

The Journal of urology. 2017 May 04 [Epub ahead of print]

Bilal Chughtai, Art Sedrakyan, Jialin Mao, Dominique Thomas, Karyn S Eilber, J Quentin Clemens, Jennifer T Anger

Department of Urology, Weill Cornell Medicine/New York-Presbyterian, New York, New York 10065. Electronic address: ., Department of Healthcare Policy and Research, Weill Cornell Medicine/New York-Presbyterian, New York, New York 10065. Electronic address: ., Department of Healthcare Policy and Research, Weill Cornell Medicine/New York-Presbyterian, New York, New York 10065. Electronic address: ., Department of Urology, Weill Cornell Medicine/New York-Presbyterian, New York, New York 10065. Electronic address: ., Department of Surgery, Division of Urology, Cedars-Sinai Medical Center, Beverly Hills, California 90211. Electronic address: ., Department of Urology, The University of Michigan Medical Center, Ann Arbor, Michigan 48109. Electronic address: ., Department of Surgery, Division of Urology, Cedars-Sinai Medical Center, Beverly Hills, California 90211. Electronic address: .

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