Poster, Podium & Video Sessions
Presentation Authors: Bilal Chughtai*, Art Sedrakyan, Jialin Mao, Dominique Thomas, New York, NY, Karyn Eilber, Jennifer Anger, Beverly Hills, CA, J. Quentin Clemens, Ann Arbor, MI
Introduction: Synthetic mesh for vaginal prolapse surgery has been placed under scrutiny, with concerns about a causal association between mesh and causation of carcinogenesis. There are a lack of data regarding the systemic response to polypropylene mesh implantation. We sought to investigate a potential link between the carcinogenesis and synthetic polypropylene mesh repairs using statewide administrative data.
Methods: Adult women undergoing surgery for pelvic organ prolapse (POP) with vaginal 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. This two-year time period was chosen because it occurred after the mesh insertion code came into use, yet allowed for long-term follow-up with respect to the outcomes of interest. The cancers were chosen based on the most common cancers occurring in women based upon data collected from the CDC and NCI.. Patients in the mesh cohort were 1:3 individually matched to a control cholecystectomy cohort based on comorbidities and procedure date. The development of carcinogensis was determined before and after matching for 1-year, 2-year and entire follow-up (up to 5 years until December 2014). Differences between groups, defined by frequency of new diagnoses of malignancy were assessed using chi-squared (χ2) tests in the entire cohort and using stratified Mantel-Haenszel χ2 tests for paired data in the matched cohort.
Results: A total of 2,301 patients underwent mesh based POP surgery between January 2008 and December 2009. 1,699 patients undergoing mesh based POP surgery were matched to 5097 patients undergoing cholecystectomy based on demographics, comorbidities and procedure date. Mesh-based surgery was not associated with an increased risk of developing a cancer diagnosis at 1-year (Risk ratio (RR) 0.41, 95% CI 0.23-0.75), 2-year (RR 0.57, 95% CI 0.39-0.84) and during entire follow up of up to 5 years (RR 0.67, 95% CI 0.53-0.84).
Conclusions: Mesh-based vaginal surgery was not associated with the development of cancers. This data refutes claims against mesh as a cause of carcinogenesis.
Source Of Funding: AUA Data Grant
Weill Cornell Medical College
Friday, May 12
8:30 AM – 8:40 AM
Saturday, May 13
8:10 AM – 8:20 AM
Sunday, May 14
9:00 AM – 4:00 PM