Endometriosis Is Not Associated With Mesh Excision in a Case-control Study
Caroline Layding1, Morgan Egnot1,2, Leslie Meyn1
1Magee-Womens Research Institute.
Urogynecology (Philadelphia, Pa.)
|May 18, 2026
Summary
Endometriosis does not appear to be a significant risk factor for polypropylene mesh excision. Other factors like age, smoking, BMI, and implantation duration are more strongly associated with mesh complications.
Area of Science:
- Gynecologic surgery
- Surgical complications
Background:
- Mesh complications, including inflammation and pain, share similarities with endometriosis.
- Chronic pelvic pain is common in patients with mesh complications.
- The specific role of endometriosis as a risk factor for mesh excision remains unclear.
Purpose of the Study:
- To investigate if a prior endometriosis diagnosis is more prevalent in patients requiring mesh excision compared to those with uncomplicated mesh implantation.
Main Methods:
- An unmatched case-control study was performed.
- Cases (n=179) underwent mesh excision; controls (n=65) had uncomplicated mesh implantation.
- Endometriosis diagnosis was confirmed via chart review and pathology reports. Logistic regression analyzed the association.
Main Results:
- Patients undergoing mesh excision were younger, had higher BMIs, and were more likely to be smokers.
- While univariate analysis showed a higher endometriosis rate in the excision group (18.4% vs. 7.7%), this was not significant after controlling for other factors.
- Independent predictors for mesh excision included younger age, smoking status, higher BMI, and longer implantation duration.
Conclusions:
- Endometriosis diagnosis is not a significant predictor of mesh excision when accounting for other established risk factors.
- Demographic and clinical factors are more influential in predicting the need for mesh excision.
