Polypropylene mesh contraindication

I am scheduled for a sacral colpopexy for POP using polypropylene mesh.  I have an autoimmune disease, Sjogren's Syndrome and was told by  colorectal surgeon who did a previous rectopexy in 2007, that synthetic meshes are contraindicated for those with autoimmune diseases.  The current surgeon who is doing the colpopexy does not know of that contraindication and told me that the mesh would be appropriate.  This is a well respected doctor from a large teaching hospital who specializes in pelvic reconstruction.  It is very difficult to find any information concerning this issue and I would appreciate any insight as whether polypropylene mesh causes complications if used in patients with autoimmune disease. Thanks.

[sherrieP]

I'd be concerned about reaction, people with autoimmune conditions have more reactionary bodies. Do you use prednisone? (Not sure what treatment of choice is for Sjogren's Syndrome.) If you do, know that pred degrades tissue integrity and mesh can migrate, not a good thing. I sure wish they had an allergy test for mesh prior to utilizing it but nothing like that exists. Is the physician doing the surgery a urogyn? I assume so based on your comments. I would suggest discussing this with an additional physician who specializes in allergies or autoimmune (not sure what that would be, maybe an internist?) to see thought process b/4 you proceed. The down side of no mesh is surgery typically needs to be redone down the road (especially in menopausal sector because of impact of estrogen loss to our tissues) so please dig deeper b/4 you make a decision. So important to have all the facts.

Please keep me in the loop on this, I'd like to know what answers you get.
Sher

[sherrieP]

I'd be concerned about reaction, people with autoimmune conditions have more reactionary bodies. Do you use prednisone? (Not sure what treatment of choice is for Sjogren's Syndrome.) If you do, know that pred degrades tissue integrity and mesh can migrate, not a good thing. I sure wish they had an allergy test for mesh prior to utilizing it but nothing like that exists. Is the physician doing the surgery a urogyn? I assume so based on your comments. I would suggest discussing this with an additional physician who specializes in allergies or autoimmune (not sure what that would be, maybe an internist?) to see thought process b/4 you proceed. The down side of no mesh is surgery typically needs to be redone down the road (especially in menopausal sector because of impact of estrogen loss to our tissues) so please dig deeper b/4 you make a decision. So important to have all the facts.

Please keep me in the loop on this, I'd like to know what answers you get.
Sher

[Sunbrella]

Thanks so much for your comment.  No, I don't take prednisone. I am followed by a rheumatologist and see him next week for discussion on this.  I would be interested if any of your forum readers with autoimmune diseases had synthetic mesh implant for POP or any other surgery.  I am surprised that there is so little written about this dilema.  Thanks.

[sherrieP]

Please let us know what the dr says, I'm very curious.
Sher

[apy402012]

dont do it i had it done and i wouldnt wish it on my worse emeny had it done march 12 2012 and it really bad after the healing start you have a pulling in your stomacl and now i having problems with my spleen

[sherrieP]

I'm so sorry to hear things did not work out ok, does the dr think it will level off in time? In general POP surgery can have up to a 12 week heal curve (longer for nerve tissues), so that may be coming into play here as well. Not sure what the significance of spleen reaction is.

Sher

[UKlady1001]

I am under investigation for sjogren's syndrome with no Anti E antibodies but I do have Anti A antibodies.  Does this mean I should not have mesh for rectoplexy and or enterocele and cyctocele?  I mentioned this to my colorectal surgeon but he didnt know of any controindications for sjogrens.

I would be very interested to know if you decide to have the operation and how it goes and send you good wishes with this.

[Sunbrella]

My urogynacologist also didn't know of issues pertaining to reactions with the use of mesh in people with Sjogren's Syndromen neither did my Rhuematologist.  I wasn't able to find anything definitive in the medical lit. so I went ahead and had the Robotic copolpexy with mesh for the vaginal vault prolapse.  It was the easiest recovery of any surgery I had.  I am now 11 weeks post-op and so far no issues.  I feel great.  I had it done at the Mayo Clinic because of past failures without the use of mesh.  I hope this helps.

[UKlady1001]

Fantastic news Sunbrella and thank you for replying.  I am so glad I caught up with your message from July.  I hope you are still healing well.  My Rhuematologist and Colorectal Consultants didnt feel that Sjogrens was a problem either with mesh operations although like you I have also read that this is a contraindication.  

Please keep me posted on how you are doing.  Thank you
Val