Peer-reviewed veterinary case report
Autoimmune syndrome after urethral sling surgery in a woman
By Hammad MAM et al.·2026·University of California, United States·View original on Europe PMC →
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Original publication title: Autoimmune syndrome induced by adjuvants (ASIA) following urethral sling placement: A case report.
Plain-English summary
A 39-year-old woman started feeling very unwell after having a synthetic mesh placed to help with urinary incontinence. Right after the surgery, she faced serious health issues like infections and a sudden drop in adrenal function, and later she continued to struggle with extreme tiredness, rapid heart rate when standing, nerve pain, trouble thinking clearly, and frequent infections. After many tests, doctors found some signs of immune system problems, leading them to suspect she had an autoimmune syndrome triggered by the mesh. She decided to have the mesh removed and replaced it with a different type of support made from her own tissue. After the surgery, her symptoms greatly improved, her bladder function returned to normal, and she felt much better overall, with complete recovery noted by three months after the surgery and continued good health a year later.
Abstract
A 39-year-old woman developed debilitating systemic symptoms following the placement of a synthetic mid-urethral sling for stress urinary incontinence. Previously in good health, she experienced sepsis and adrenal crisis immediately postoperatively, followed by persistent symptoms including fatigue, postural orthostatic tachycardia syndrome (POTS), neuropathic pain, cognitive dysfunction, autonomic instability, and recurrent infections. Despite extensive multispecialty evaluations, no definitive diagnosis was initially reached. Laboratory testing later revealed positive ANA and mild immune dysregulation. Given her complex autoimmune history, strong family predisposition, and the temporal association with mesh implantation, her presentation was suspected to be consistent with autoimmune syndrome induced by adjuvants (ASIA). She elected to undergo surgical removal of the synthetic sling with placement of an autologous rectus fascia pubovaginal sling. Postoperatively, the patient experienced significant resolution of her symptoms, restored bladder function, and improved quality of life. This case demonstrates a temporal association consistent with ASIA, with complete symptom resolution by 3 months post-explant and sustained well-being at 1 year.
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Search related cases →Original publication on Europe PMC: https://europepmc.org/article/MED/41561794