Muller, P, Gurol-Urganci, I, Thakar, R et al. · BJOG : an international journal of obstetrics and gynaecology · 2022 · DOI
This study looked at whether a surgical mesh implant used to treat urinary leakage in women increases the risk of developing systemic diseases like autoimmune conditions, fibromyalgia, or ME/CFS. Researchers compared nearly 89,000 women who received mesh surgery to about 3,400 women who had surgery without mesh, following them for up to 10 years. The study found no evidence that mesh surgery increased the risk of these systemic conditions.
ME/CFS patients and advocates have raised concerns about whether surgical mesh implants may trigger or exacerbate systemic autoimmune and post-viral conditions. This large, population-based study directly addresses those safety concerns by examining long-term risks, providing evidence relevant to informed decision-making for patients considering this common surgical procedure.
This study does not prove that mesh surgery is entirely safe for all patients, nor does it exclude the possibility of mesh-related complications in specific subgroups. Observational studies cannot definitively establish causation, and reliance on hospital admission records may miss milder cases of ME/CFS or autoimmune disease not requiring hospitalization. The study also cannot rule out individual sensitivity or rare adverse events occurring in a small number of patients.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Muller, P, Gurol-Urganci, I, Thakar, R, Ehrenstein, M R, Van Der Meulen, J, & Jha, S (2022). Impact of a mid-urethral synthetic mesh sling on long-term risk of systemic conditions in women with stress urinary incontinence: a national cohort study.. BJOG : an international journal of obstetrics and gynaecology. https://doi.org/10.1111/1471-0528.16917
BibTeX
@article{mecfsatlas-muller-2022-impact-mid,
author = {Muller, P and Gurol-Urganci, I and Thakar, R and Ehrenstein, M R and Van Der Meulen, J and Jha, S},
title = {Impact of a mid-urethral synthetic mesh sling on long-term risk of systemic conditions in women with stress urinary incontinence: a national cohort study.},
journal = {BJOG : an international journal of obstetrics and gynaecology},
year = {2022},
doi = {10.1111/1471-0528.16917},
note = {PubMed: 34524725},
url = {https://www.mecfsatlas.com/evidence/muller-2022-impact-mid},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/muller-2022-impact-mid
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