The American Urogynecologic Society/The Society of Gynecologic SurgeonsHistopathologic changes of porcine dermis xenografts for transvaginal suburethral slings
Section snippets
Patients
Twelve of 66 subjects who previously underwent Cooper's ligament slings with porcine dermal implants have undergone reoperation for sling revision. At the time of reoperation, grafts were visible in all subjects, and biopsies were sent in 7 subjects for pathologic evaluation. Six of these specimens were available for histopathologic analysis. Office charts and operative reports were reviewed after Institutional Review Board approval.
Implant processing
Pelvicol™ is a collagen matrix manufactured using a process
Clinical characteristics
We have used porcine dermis xenografts in 66 transvaginal sling procedures between November 2001 and May 2003. Twelve subjects underwent reoperation, representing 18% of the total cohort who had xenografts placed. Ten subjects had urinary retention requiring prolonged catheterization, and 2 women cured on postoperative urodynamics 14 weeks after surgery had recurrent urodynamic stress incontinence. Indications for urethrolysis included complete urinary retention, worsening urge incontinence, or
Comment
There is considerable controversy in the literature regarding the choice of material for sling procedures. Although many authors have described failure rates for sling procedures, few have described the associated in vivo histologic changes and correlated them with clinical outcomes. High complication rates associated with synthetic materials,13, 14 and the increased operative time and prolonged recovery associated with harvesting fascia lata have limited their usage.4, 15, 16 The durability of
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Infection susceptibility of crosslinked and non-crosslinked biological meshes in an experimental contaminated environment
2015, American Journal of SurgeryCitation Excerpt :Crosslinking appears to decrease the pore size of biological meshes to a pore size small enough to provide a suitable housing for bacteria while preventing access of macrophages, fibroblasts, blood vessels, and collagen fibers into the pores.31,32 This may lead to encapsulation rather than remodeling of the mesh.33,34 However, not all crosslinked meshes have similar densities of crosslinking because of differences in processing.
Host Response to Biomaterials for Pelvic Floor Reconstruction
2015, Host Response to Biomaterials: The Impact of Host Response on Biomaterial SelectionImplantation of a porcine acellular dermal graft in a primate model of rotator cuff repair
2012, Journal of Shoulder and Elbow SurgerySpherical indentation of free-standing acellular extracellular matrix membranes
2012, Acta Biomaterialia
Presented at the Joint Scientific Meeting of the Society of Gynecologic Surgeons and the American Urogynecologic Society, San Diego, Calif, July 29-31, 2004.