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Experimental study of a new original mesh developed for pelvic floor reconstructive surgery

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Abstract

Introduction and hypothesis

Most synthetic meshes used in transvaginal surgery are made of polypropylene, which has a stable performance, but does not easily degrade in vivo. However, mesh-related complications are difficult to address and have raised serious concerns. A new biomaterial mesh with good tissue integration and few mesh-related complications is needed. To evaluate the effect of a new bacterial cellulose (BC) mesh on pelvic floor reconstruction following implantation in the vagina of sheep after 1 and 12 weeks.

Methods

The meshes were implanted in the submucosa of the posterior vagina wall of sheep. At 1 and 12 weeks after surgery, mesh–tissue complex (MTC) specimens were harvested for histological studies and biomechanical evaluation. At 12 weeks after surgery, MTC specimens were biomechanically assessed by a uniaxial tension “pulley system”.

Results

The BC mesh elicited a higher inflammatory response than Gynemesh™PS at both 1 and 12 weeks after implantation. Twelve weeks after implantation, the BC mesh resulted in less fibrosis than Gynemesh™PS. Compared with the Gynemesh™PS group, the BC mesh group had increased mRNA expression of MMP-1, MMP-2, and MMP-9 (P < 0.05), but decreased expression of the anti-inflammatory factor IL-4 (P < 0.05). Twelve weeks after implantation, the ultimate load and maximum elongation percentage of the BC mesh were significantly lower than those of Gynemesh™PS.

Conclusions

The BC mesh could not be a promising biomaterial for pelvic floor reconstructive surgery unless the production process and parameters were improved.

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Acknowledgements

The animal study was conducted at Beijing Key Laboratory of Pre-clinical Research and Evaluation for Cardiovascular Implant Materials. The authors thank Bin Li, Boqing Yang, and Liujun Jia, who participated in the anesthesia procedure of the sheep.

Funding

This study received financial support from the National Natural Science Foundation of China (number: 81771561), and Strategic Priority Research Program of the Chinese Academy of Sciences (XDA16010102).

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, No.1 Shuai Fu Road, Dongcheng District, Beijing, People’s Republic of China

    Fang-Fang Ai, Meng Mao, Ye Zhang, Jia Kang & Lan Zhu

  2. Department of Obstetrics and Gynecology, Xuanwu Hospital, Capital Medical University, Beijing, People’s Republic of China

    Fang-Fang Ai

Authors
  1. Fang-Fang Ai
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  2. Meng Mao
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  4. Jia Kang
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  5. Lan Zhu
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Corresponding author

Correspondence to Lan Zhu.

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Details of ethics approval

The study was approved by the ethics committee of FUWAI Hospital, Chinese Academy of Medical Sciences (0079-2-36-HX(X)).

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Ai, FF., Mao, M., Zhang, Y. et al. Experimental study of a new original mesh developed for pelvic floor reconstructive surgery. Int Urogynecol J 31, 79–89 (2020). https://doi.org/10.1007/s00192-019-03947-4

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  • DOI: https://doi.org/10.1007/s00192-019-03947-4

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