As a 2016 Urology Care Foundation™ (UCF) grant recipient, I have been able to build a fruitful academic career and successful research collaborations, specifically in the areas of pelvic organ prolapse (POP), incontinence, and voiding dysfunction. One area of patient and medicolegal concern that has been interesting to me is the long-term safety of polypropylene mesh. To that end, the UCF awarded our team the grant, “Long-Term Systemic Effects of Vaginal Mesh: Seeking the Truth.” With support from Dr Jennifer Anger and Dr J. Quentin Clemens, we attempted to better elucidate the relationship between carcinogenesis and autoimmune diseases with polypropylene mesh.

Following the Food and Drug Administration safety communication in July 2011 on transvaginal placement of surgical mesh for POP, there was increased discussion regarding its use and overall safety. In a similar vein, our previous work has found an association between an increased risk of reinterventions within 1 year and urinary retention following mesh procedures for POP.¹ Despite the well-documented risk of mesh erosion and the substantial need for surgical reintervention, there was a paucity of data about the long-term risks of a foreign body reaction due to the breakdown of polypropylene mesh. With the support of the UCF grant, we used a large prospective administrative data base from New York State to determine the long-term risks of autoimmune disease and cancer in both men and women. We were able to demonstrate there was no long-term risk of cancer or autoimmune disease with polypropylene mesh. These successful collaborations and projects paved the way for numerous presentations at the National American Urological Association Meetings and Society of Urodynamics and Female Urology Meetings.

This successful project led to further studies where I was able to uncover the unique complications of mesh-based surgery vs traditional repair. Our studies showed the relationship between the quantity of mesh was predictive of more long-term complications vs traditional POP surgery.² We also demonstrated the impact of regulatory warnings from the Food and Drug Administration in affecting physician behavior with the use of mesh. Additionally, these studies explored the decline in the use of mesh in the postwarning period, particularly in low- to medium-volume and nonacademic centers. Ultimately, this body of research has led to a more complete and nuanced understanding of the real-world utilization and risks of these polymer meshes in the field of POP and incontinence.

The grant awarded by UCF paved the way for me to publish over 275 peer-reviewed articles and 4 textbooks. As a result of my research and clinical work, I have been granted the opportunity to transition into a leadership role to further expand my academic work. I am now the chief of urology at Plainview and Syosset Hospital in Plainview, New York. I look forward to utilizing the teamwork, leadership, and research skills that I gained from the UCF grant to build a successful academic department.