Polymers for Pelvic Floor Repair: Current State and Future Prospects

Surgical repair of pelvic organ prolapse and stress urinary incontinence frequently relies on polymeric biomaterials in sutures, meshes, and membranes to provide structural support during tissue healing and beyond. Polypropylene has long served as the default material owing to its strength, durability, and processability, but the chronic foreign body response and mechanical mismatch between stiff implants and viscoelastic pelvic tissue have been linked to complications, including mesh contraction, exposure, and dyspareunia. These limitations, together with regulatory actions on transvaginal mesh, have driven interest in alternative permanent polymers and, increasingly, in resorbable materials designed to provide temporary reinforcement during tissue remodeling.

The objective of this review was to summarize the characteristics, advantages, and limitations of polymers currently used or under investigation for load-bearing and reinforcement urogynecologic implants.

This is a narrative review of polymeric biomaterials for urogynecologic mesh, membrane, and suture applications, based on a search of PubMed and Web of Science for in vitro and in vivo studies of polymer-based devices.

Permanent materials covered include polypropylene, polyvinylidene fluoride, polytetrafluoroethylene, polyethylene terephthalate, polyamide, and polyurethane. Resorbable materials include lactide- and caprolactone-based polyesters, polydioxanone, polyhydroxyalkanoates (notably poly-4-hydroxybutyrate), and natural polymers such as silk fibroin, bacterial cellulose, and collagen. The use of advanced manufacturing techniques and functionalizing strategies to improve tissue reinforcement and healing is also highlighted.

The review provides a reference point for the design of next-generation urogynecologic implants, which requires integrated consideration of polymer properties, scaffold architecture, and host biology across the course of tissue remodeling.