Polypropylene mesh slings and cancer: An incidental finding or association?

Excerpt

If polypropylene mesh slings were found to lead to malignancy, even in a small number of cases, it would lead to clear practice changes. The current report describes a case of clear cell carcinoma diagnosed in a patient who was also noted to have an exposed midurethral sling. Clear cell carcinoma is a rare tumor that can occur primarily within the urethra or the vagina. In the vagina it is often associated with in utero diethylstilbestrol (DES) exposure, while in the urethra the majority of such cancers are associated with a urethral diverticulum. The report by Lin et al. [1] describes a patient who presented with urinary retention and symptoms of a urinary tract infection (UTI) who was found upon examination to have mesh exposure in the vaginal fornix and an inflamed and tender anterior vaginal wall. She received a transvaginal tape obturator (TVTo) (Gynecare, Johnson & Johnson, Somerville, NJ, USA) 10 years earlier. The exposed mesh was excised, but within 2 months the vaginal wall was friable; ultimately, invasive clear cell carcinoma was diagnosed. …