Surgical mesh implants, often used for a hernia or gynecological repair, maybe the reason so many patients report symptoms of an autoimmune disorder, according to a University of Alberta rheumatologist.

"In my practice, I studied 40 patients who had mesh implants and found that almost all of them had symptoms such as chronic fatigue, cognitive impairment known as "brain fog," muscle and joint pain "fibromyalgia," feverish temperature, and dry eyes and dry mouth," said Jan Willem Cohen Tervaert, director of the Division of Rheumatology at the U of A.

"Of those patients, 45% developed an autoimmune disorder such as lupus or rheumatoid arthritis. And in the patients who had allergies before the implant, they were significantly worse after," said Tervaert.

Cohen Tervaert presented his study results at the 11th International Conference on Autoimmunity in Lisbon in May 2018, and will soon publish them in a leading journal.

"My study is small; however, it is beyond coincidence that these symptoms, which often go untreated or even unacknowledged by some doctors, exist among so many mesh implant patients. A larger study is needed to confirm whether, in fact, the implanted mesh is to blame," he added. 

"When a foreign body is put into the body, there is an instant activation of the immune system. It continues to fight the foreign body and eventually, over time, fatigues and becomes dysfunctional," Tervaert said.

"Large-scale studies have shown that patients with breast implants have more symptoms of ASIA (autoimmune/autoinflammatory syndrome induced by adjuvants) and an increased risk to develop an autoimmune disorder. And in animal models, it has been demonstrated that these silicones can induce autoimmune diseases if the animals have the right genetics," Tervaert said.

What concerned patients need to know

Cohen Tervaert said there is no need for patients with mesh implants to panic. "Many patients do not develop symptoms or disease. You must have the genes in the first place," Tervaert said.

Concerned patients should discuss risks with their physicians about existing or future mesh implants. One guiding rule of thumb could be whether or not a patient has pre-existing allergies, added Cohen Tervaert.

He noted that pre-existing allergies were present in 80% of breast implant patients—the same percentage who had allergies when mesh implantation caused problems in his patient group.

"In the Netherlands, the government informed all plastic surgeons that if patients who consider breast implants have pre-existing allergies, they should consider not doing the surgery at all. At the very least, we should be warning patients with allergies that their symptoms may worsen after a mesh is put in," Tervaert noted.