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Do preoperative cytokine levels offer a prognostic factor for polypropylene mesh erosion after suburethral sling surgery for stress urinary incontinence?

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Abstract

When polypropylene meshes are used in reconstructive urogynecological surgery, the erosion rates vary from 3.3% to 14% and causative factors for such erosions are still unknown in many cases. Therefore, the aim of our study was to establish the role of immunologic factors in the process of polypropylene tapes erosions after suburethral sling procedures. Serum concentrations of tumor necrosis factor α, interleukin (IL)-2, IL-4, IL-5, IL-10, and interferon (IFN)-γ were estimated in 123 patients suffering from stress urinary incontinence preoperatively and during 12 months follow-up using Human Th1/Th2 Cytokine Cytometric Bead Array I kit. The same immunological assessment was performed in each case of detected tape erosion. Statistical calculation was performed using UNIVARIATE, CORR, and NPAR1WAY procedures from Statistical Analysis System. The unpaired Student’s t test, nonparametric Mann–Whitney U test, and Wilcoxon tests were used. Preoperative IFN-γ concentration was significantly higher in women with subsequent polypropylene mesh erosion when compared to women with successful outcome (p < 0.05). Th1 cytokine profile may be related to the risk of the vaginal erosions following placement of polypropylene meshes. The way to lower erosion rate may involve exclusion of the patients immunologically prone to synthetic material erosion. The factor which can help to select such patients could be preoperative level of IFN-γ.

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Funding

This paper was supported by Polish Ministry of Science and Higher Education (KBN grant No 2P0E07927).

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Authors and Affiliations

  1. Second Department of Gynecological Surgery, Skubiszewski Medical University of Lublin, 8 Jaczewskiego Street, 20-954, Lublin, Poland

    Tomasz Rechberger, Katarzyna Jankiewicz, Aneta Adamiak & Paweł Miotla

  2. Department of Reproductive Immunology, Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wroclaw, Poland

    Agnieszka Chrobak

  3. Department of Gynecology and Gynecological Oncology, Military Institute of Health Sciences, University School of Medicine, Warsaw, Poland

    Małgorzata Jerzak

Authors
  1. Tomasz Rechberger
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  2. Katarzyna Jankiewicz
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  3. Aneta Adamiak
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  4. Paweł Miotla
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  5. Agnieszka Chrobak
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  6. Małgorzata Jerzak
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Correspondence to Tomasz Rechberger.

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Rechberger, T., Jankiewicz, K., Adamiak, A. et al. Do preoperative cytokine levels offer a prognostic factor for polypropylene mesh erosion after suburethral sling surgery for stress urinary incontinence?. Int Urogynecol J 20, 69–74 (2009). https://doi.org/10.1007/s00192-008-0731-7

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  • DOI: https://doi.org/10.1007/s00192-008-0731-7

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