Sports Hernia Patients and Classic Hernia Patients and Hernia Mesh Removal
Autoimmune diseases occur when the body’s defense system mistakenly attacks the normal cells of the body. This can result in chronic fatigue, myalgias, joint pain, irritable bowel, rashes, and more. It has been suggested that the inflammation caused by the implantation of mesh causes the body’s white body cells and foreign body cells to become overly active and thereby causing autoimmune disease. There are several studies that followed patients after mesh hernia repair. These surgical patients did not develop autoimmune disease at a rate any higher than the general population. This would suggest that mesh is not a cause of autoimmune disease. But the studies did report that if a patient has multiple allergies before surgery they are at increased risk to suffer autoimmune disease after mesh hernia repair. If you already have an autoimmune disease, then you should not have a mesh hernia repair. (Review the articles by Chughtai and Clancy, links below)
But I think is a more important question is: “If the mesh is removed will the autoimmune symptoms improve?” There is only one article that I could find on the subject. (Review the article by Cohen.) In his article, if a patient developed autoimmune disease after implantation of mesh and then had the mesh removed then their autoimmune disease improved. The fact the removing mesh helps autoimmune is supported by the fact that there is a lot more evidence that if a woman develops autoimmune disease after a silicone breast implant, then the autoimmune disease will improve if the implant is removed. (Review the article by Maijers, links below)
I have had three patients who developed autoimmune disease after mesh hernia repair. All of them improved after the mesh was removed.
In summary, there is evidence that if after a mesh hernia repair you develop autoimmune disease then there is a good chance that disease will improve if the mesh is removed.
If you already have an autoimmune disease, then avoid a mesh implant.
if you have questions.
Bill Brown MD
Articles suggest that mesh does not increase risk of autoimmune disease
Is vaginal mesh a stimulus of autoimmune disease?
Chughtai B, Sedrakyan A, Mao J, Eilber KS, Anger JT, Clemens JQ. Am J Obstet Gynecol. 2017 05;216(5):495.e1-495.e7
Hernia repair with polypropylene mesh is not associated with an increased risk of autoimmune disease in adult men
Chughtai B, Thomas D, Mao J, Eilber K, Anger J, Clemens JQ, Sedrakyan A.
Hernia. 2017 08;21(4):637-642.
Polypropylene mesh and systemic side effects in inguinal hernia repair: current evidence.
Clancy C, Jordan P, Ridgway PF.
Ir J Med Sci. 2019 Mar 27
Article that removing the mesh autoimmune disease improves
Cohen Tervaert JW. Autoinflammatory/autoimmunity syndrome induced by adjuvants
(ASIA; Shoenfeld’s syndrome): A new flame. Autoimmun Rev. 2018
Dec;17(12):1259-1264. doi: 10.1016/j.autrev.2018.07.003. Epub 2018 Oct 12.
Review. PubMed PMID: 30316995.
Article that removing a silicone breast implant will improve autoimmune disease
Women with silicone breast implants and unexplained systemic symptoms: a descriptive cohort study.
Maijers MC, de Blok CJ, Niessen FB, van der Veldt AA, Ritt MJ, Winters HA, Kramer MH, Nanayakkara PW. Neth J Med. 2013 Dec;71(10):534-40