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Host reaction to vaginally inserted collagen containing polypropylene implants in sheep.
Andrew Feola1, Masayuki Endo1, Iva Urbankova2
1Center for Surgical Technologies, Faculty of Medicine, KU Leuven, Leuven, Belgium; Department of Development and Regeneration, Organ Systems Cluster, Faculty of Medicine, KU Leuven, Leuven, Belgium.
American Journal of Obstetrics and Gynecology
|December 3, 2014
Summary
This study found that vaginal mesh implants were less stiff than abdominal implants and altered biomechanical properties. Collagen coatings did not reduce complications in this sheep model.
Area of Science:
- Biomedical Engineering
- Materials Science
- Surgical Innovation
Background:
- Pelvic organ prolapse and stress urinary incontinence often require surgical repair using synthetic meshes.
- Polypropylene mesh is a common material, but its biomechanical properties and long-term effects in vivo require further characterization.
- Collagen augmentation aims to improve biocompatibility and reduce complications associated with synthetic meshes.
Purpose of the Study:
- To evaluate the biomechanical and morphometric effects of vaginal versus abdominal polypropylene mesh implantation in a sheep model.
- To assess the impact of different collagen augmentations on polypropylene mesh performance.
- To compare the outcomes of native vaginal and abdominal tissues with implanted mesh explants.
Main Methods:
- Forty-two Texel sheep underwent implantation of polypropylene mesh (Avaulta Solo) or collagen-coated meshes (Avaulta Plus, Ugytex) in either the rectovaginal septum or an abdominal incisional defect.
- Explants were harvested at 60 or 180 days for biomechanical testing (passive biaxial tensiometry, active contractility) and histological analysis.
- Control groups included nonimplanted animals and native vaginal and abdominal tissues.
Main Results:
- Vaginal mesh explants demonstrated a 2.4-fold increase in stiffness compared to native vaginal tissue.
- Abdominal mesh explants were 1.3-fold stiffer than native abdominal wall tissue and 1.9-fold stiffer than vaginal explants.
- Collagen-coated meshes showed a significant reduction in contractile force (16-fold) by 180 days, but did not reduce graft-related complications.
Conclusions:
- Vaginal mesh implantation results in less stiff explants compared to abdominal mesh implantation.
- Both vaginal and abdominal mesh implantation significantly alter the passive and active biomechanical properties of the native tissues.
- Collagen augmentation of polypropylene meshes did not appear to reduce graft-related complications in this ovine model.