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Hernia repair with polypropylene mesh is not associated with an increased risk of autoimmune disease in adult men

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Abstract

Purpose

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).

Study design

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.

Results

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).

Conclusions

Mesh-based hernia repair was not associated with the development of autoimmune diseases compared to those undergoing routine screening colonoscopy.

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Acknowledgements

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Authors and Affiliations

  1. Department of Urology, Weill Cornell Medicine/New York-Presbyterian Hospital, New York, 425 East 61st Street, 12th Floor, New York, 10065, USA

    B. Chughtai & D. Thomas

  2. Department of Healthcare Policy and Research, Weill Cornell Medicine/New York-Presbyterian, New York, New York, 10065, USA

    J. Mao & A. Sedrakyan

  3. Department of Urology, Cedars-Sinai Medical Center, Beverly Hills, CA, 90211, USA

    K. Eilber & J. Anger

  4. Department of Urology, The University of Michigan Medical Center, Ann Arbor, MI, 48109, USA

    J. Q. Clemens

Authors
  1. B. Chughtai
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  2. D. Thomas
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  3. J. Mao
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  4. K. Eilber
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  5. J. Anger
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  6. J. Q. Clemens
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  7. A. Sedrakyan
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Corresponding author

Correspondence to B. Chughtai.

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Conflict of interests

BC declares no conflict of interest. DT declares no conflict of interest. JM declares no conflict of interest. KE declares conflict of interest related to being an investigator for Boston Scientific, Astellas and Allergan not directly related to the submitted work. JA declares conflict of interest related to being an investigator/expert witness for Boston Scientific Corporation not directly related to the submitted work. JQC declares no conflict of interest. AS declares a conflict of interest receiving grants from the US Food and Drug Administration not directly related to the submitted work.

Ethical statement

For this type of study formal consent was not required.

Statement of human and animal rights

This article does not contain any studies with animals performed by any of the authors. This study used deidentified administrative data from humans.

Informed consent

This study did not require informed consent because this was a retrospective study using deidentified administrative data.

Funding

This work was supported by the American Urological Association Data Grant.

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Chughtai, B., Thomas, D., Mao, J. et al. Hernia repair with polypropylene mesh is not associated with an increased risk of autoimmune disease in adult men. Hernia 21, 637–642 (2017). https://doi.org/10.1007/s10029-017-1591-1

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  • DOI: https://doi.org/10.1007/s10029-017-1591-1

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