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Research Letter
January 9, 2019

Association of Transvaginal Mesh Complications With the Risk of New-Onset Depression or Self-harm in Women With a Midurethral Sling

Author Affiliations
  • 1Department of Surgery, Western University, London, Ontario, Canada
  • 2Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada
  • 3Institute for Clinical Evaluative Sciences, London, Ontario, Canada
  • 4Department of Obstetrics & Gynecology, University of Edmonton, Edmonton, Alberta, Canada
  • 5Department of Obstetrics & Gynecology, Western University, London, Ontario, Canada
JAMA Surg. Published online January 9, 2019. doi:10.1001/jamasurg.2018.4644

Midurethral mesh sling procedures are the criterion standard treatment for female stress incontinence and account for more than 90% of incontinence procedures. However, regulatory warnings about transvaginal mesh complications, lawsuits, and media scrutiny have resulted in substantial public doubts about their safety.1 A survey of women with transvaginal mesh complications identified the negative psychological trajectories for women after attempts at surgical correction,2 but the relative risk of psychiatric illness associated with these complications has not been quantified. Our objective for this study was to determine whether the risk of depression or self-harm behavior was greater among women with transvaginal mesh complications that required surgical intervention compared with women who did not undergo such surgical correction.

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