Stress Incontinence Surgery Does Not Cause Pelvic Malignancy: A Population-Based Cohort Study

Area of Science:

• Urogynecology
• Oncology
• Epidemiology

Background:

• Stress urinary incontinence surgery is a common procedure for women.
• Concerns exist regarding potential long-term risks, including pelvic malignancies, associated with surgical mesh.
• Understanding the oncological outcomes of stress urinary incontinence surgery is crucial for patient counseling and clinical practice.

Purpose of the Study:

• To investigate the association between stress urinary incontinence surgery (mesh and nonmesh) and the subsequent development of pelvic malignancies.
• To compare the risk of pelvic cancers in women who underwent stress urinary incontinence surgery versus a control group.

Main Methods:

• Retrospective cohort study of women in Ontario, Canada (2002-2015).
• Inclusion criteria: women without prior pelvic malignancy undergoing stress urinary incontinence surgery.
• Primary outcome: composite of any pelvic malignancy; secondary outcome: individual cancer types. Survival analysis using Cox proportional-hazards model.

Main Results:

• 74,968 women underwent stress urinary incontinence surgery; 5,505,576 in the control group.
• Median follow-up of 8.5 years.
• Women who had stress urinary incontinence surgery had a significantly reduced risk of pelvic malignancy (mesh: HR 0.68; nonmesh: HR 0.37) compared to controls, independent of surgical approach.

Conclusions:

• Stress urinary incontinence surgery, whether using mesh or nonmesh, is not associated with an increased risk of pelvic malignancy.
• A reduced risk of pelvic malignancy was observed following stress urinary incontinence surgery in a large, population-based cohort.
• These findings support the safety of stress urinary incontinence surgery regarding long-term oncological outcomes.