Linder Brian J, Trabuco Emanuel C, Carranza Daniel A, Gebhart John B, Klingele Christopher J, Occhino John A
Department of Urology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
Department of Obstetrics and Gynecology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
Int Urogynecol J. 2016 Sep;27(9):1333-6. doi: 10.1007/s00192-016-2961-4. Epub 2016 Feb 10.
To evaluate the carcinogenic potential of implanted synthetic mesh midurethral slings in the treatment of female stress urinary incontinence.
We identified female patients undergoing implantation of mesh materials for stress urinary incontinence at our institution from 1 January 2002 to 31 December 2012. This was accomplished by querying the medical records for CPT code 57288 ("sling operation for stress incontinence") and a subsequent chart review to identify patients who underwent synthetic mesh sling placement. Medical records were then evaluated for the documentation of bladder, urethral, vaginal, cervical, uterine or ovarian cancers via the International Classification of Disease (ninth edition) coding. A chart review of patients with a cancer diagnosis was performed for verification of the diagnosis and evaluation of the temporal relationship with sling placement.
During the study period, 2,474 patients underwent polypropylene midurethral sling placement. The median age was 57 years (IQR 47, 69) and the median follow-up was 60 months (IQR 23.3, 94.9). Overall, 51 patients also had a cancer diagnosis (8 bladder cancers, 7 vaginal malignancies, 8 ovarian carcinomas, 26 endometrial cancers, 2 cervical malignancies); however, only 2 cancers (0.08 %, 2 out of 2,474) developed following sling placement (a vaginal melanoma 3 years after sling placement and an ovarian tumor 1 year after sling placement). No cases of sarcoma formation, bladder, urethral or squamous cell carcinomas were identified.
With a median follow-up of 5 years after synthetic midurethral sling placement, development of pelvic malignancy was rare (0.08 %) and unlikely to be secondary to foreign body reaction from the implanted material.
评估植入合成网片的中段尿道吊带术治疗女性压力性尿失禁的致癌潜力。
我们确定了2002年1月1日至2012年12月31日在我院接受网片材料植入治疗压力性尿失禁的女性患者。通过查询CPT编码57288（“压力性尿失禁吊带手术”）的病历记录，并随后进行病历审查以确定接受合成网片吊带植入的患者。然后通过国际疾病分类（第九版）编码评估病历记录中膀胱、尿道、阴道、宫颈、子宫或卵巢癌的记录情况。对癌症诊断患者的病历进行审查，以核实诊断并评估与吊带植入的时间关系。
在研究期间，2474例患者接受了聚丙烯中段尿道吊带植入。中位年龄为57岁（四分位间距47，69），中位随访时间为60个月（四分位间距23.3，94.9）。总体而言，51例患者也被诊断患有癌症（8例膀胱癌、7例阴道恶性肿瘤、8例卵巢癌、26例子宫内膜癌、2例宫颈癌）；然而，只有2例癌症（0.08%，2474例中的2例）在吊带植入后发生（1例阴道黑色素瘤在吊带植入后3年发生，1例卵巢肿瘤在吊带植入后1年发生）。未发现肉瘤形成、膀胱、尿道或鳞状细胞癌病例。
合成中段尿道吊带植入术后中位随访5年，盆腔恶性肿瘤的发生罕见（0.08%），不太可能继发于植入材料的异物反应。
