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Impact of a mid-urethral synthetic mesh sling on long-term risk of systemic conditions in women with stress urinary incontinence, 2021, Mueller et al

Discussion in 'ME/CFS research' started by Andy, Sep 16, 2021.

  1. Andy

    Andy Committee Member

    Messages:
    21,963
    Location:
    Hampshire, UK
    Full title: Impact of a mid-urethral synthetic mesh sling on long-term risk of systemic conditions in women with stress urinary incontinence: a national cohort study

    Abstract
    Objective

    To compare the incidence of systemic conditions between women who had surgical treatment for stress incontinence with mesh and without mesh.

    Design
    National cohort study.

    Setting
    English National Health Service.

    Population
    Women with no previous record of systemic disease who had first-time urinary incontinence surgery between 1 January 2006 and 31 December 2013, followed up to the earliest of 10 years or 31 March 2019.

    Methods
    Competing-risks regression was used to estimate hazard ratios (HR), adjusted for patient characteristics, with HR > 1 indicating increased incidence following mesh surgery.

    Main outcome measures
    First post-operative admission with a record of autoimmune disease, fibromyalgia or myalgic encephalomyelitis up to 10 years following the first incontinence procedure. Competing-risks regression was used to estimate hazard ratios (HR) of admission, adjusted for patient characteristics, with HR > 1 indicating increased incidence following mesh surgery.

    Results
    The cohort included 88 947 women who had mesh surgery and 3 389 women who had non-mesh surgery. Both treatment groups were similar with respect to age, socio-economic deprivation, comorbidity, and ethnicity. The 10-year cumulative incidence of autoimmune disease, fibromyalgia or myalgic encephalomyelitis was 8.1% (95% confidence interval 7.9% to 8.3%) in the mesh group and 9.0% (8.0% to 10.1%) in the non-mesh group (adjusted HR 0.89 [0.79 to 1.01]; p = 0.07). A sensitivity analysis including only autoimmune diseases as an outcome returned a similar result.

    Conclusions
    These findings do not support claims that synthetic mesh slings cause systemic disease.

    Paywall, https://obgyn.onlinelibrary.wiley.com/doi/10.1111/1471-0528.16917
     
  2. Arnie Pye

    Arnie Pye Senior Member (Voting Rights)

    Messages:
    6,097
    Location:
    UK
    This research paper worries me. Are researchers trying to find evidence to "rehabilitate" mesh in the eyes of women? Because if so, this puts them in the position of being (potentially) happy to be torturers.
     
  3. Trish

    Trish Moderator Staff Member

    Messages:
    52,339
    Location:
    UK
    They really should have included in the study reporting of both whether the treatment was effective, and whether it was safe, including issues like pain.
     
  4. DokaGirl

    DokaGirl Senior Member (Voting Rights)

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    3,664
  5. Dolphin

    Dolphin Senior Member (Voting Rights)

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    5,108

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