Biomaterials in urinary incontinence and treatment of their complications

Sangster, Philippa; Morley, Roland

doi:10.4103/0970-1591.65394

Cited by 17 publications

(12 citation statements)

References 66 publications

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“…Since the start of this type of treatment in 1938 [11] , many materials and devices have been developed for this use. Regrettably most methods have limited efficacy, short duration of the effect or both.…”

Section: Discussionmentioning

confidence: 99%

Para-Urethral Injections with Urolastic® for Treatment of Female Stress Urinary Incontinence: Subjective Improvement and Safety

Vries

Breda²,

Fernandes³

et al. 2017

Urol Int

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Introduction: Female stress urinary incontinence (SUI) is often treated surgically. Urethral bulking agents are a minimally invasive alternative, especially in patients suffering from intrinsic sphincter deficiency, but often with limited long-term efficacy. Urolastic® is a non-deformable, non-resorbable silicone elastomer that is used as an injectable. Its properties might result in a more durable response after injection. If this durability factor can be combined with a low complication rate, this can become a useful treatment option. We therefore assessed the subjective improvement and safety after treatment with Urolastic®. Materials and Methods: In 2 Dutch hospitals, 65 patients were treated with Urolastic®. The subjective improvement was assessed and the medical charts were reviewed for complications that appeared during the follow-up period. The complications were classified using the Clavien-Dindo classification. Results: We found that 76-88% of the patients showed subjective improvement at 12-25 months follow-up. The rate of improvement experienced was 50-70%. The rate of complications classified as Clavien-Dindo >II was 24-33%. The 12 patients with 75-100% subjective improvement after 2 months, showed 85% improvement after a median of 25 months. Conclusions: With careful patient selection, Urolastic® seems to be a safe, durable and effective treatment option for female SUI.

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Section: Discussionmentioning

confidence: 99%

Para-Urethral Injections with Urolastic® for Treatment of Female Stress Urinary Incontinence: Subjective Improvement and Safety

Vries

Breda²,

Fernandes³

et al. 2017

Urol Int

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“…Likely to the materials intended for abdominal wall repair, the ideal biomaterial should be sterile, durable, not carcinogenic, but also withstand remodeling by body tissues, have minimal risk of infection and rejection, and ultimately be cost-effective (Gigliobianco, Regueros, Osman, et al, 2015;Todros, Pavan, & Natali, 2015;Winters, Fitzgerald, & Barber, 2006). Additionally, once implanted the ideal biomaterial should possess adequate mechanical properties, withstand shrinkage, and be pliable and easy to manipulate during surgery (Sangster & Morley, 2010;Wu, 2008). However, in comparison to the abdomen, the pelvic floor is a more complex tissue, with an heterogeneous architecture that include muscles, connective tissue and organs (Herschorn, 2004), and whose composition changes significantly according to several factors, such as age, pregnancy and menopause (Machin & Mukhopadhyay, 2011).…”

Section: The Advent Of Surgical Meshes In Pop Surgerymentioning

confidence: 99%

The use of polymeric meshes for pelvic organ prolapse: Current concepts, challenges, and future perspectives

et al. 2019

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Pelvic organ prolapse (POP) is one of the most common chronic disorders in women, impacting the quality of life of millions of them worldwide. More than 100 surgical procedures have been developed over the decades to treat POP. However, the failure of conservative strategies and the number of patients with recurrence risk have increased the need for further adjuvant treatments. Since their introduction, surgical synthetic meshes have dramatically transformed POP repair showing superior anatomic outcomes in comparison to traditional approaches. Although significant progress has been attained, among the meshes in clinical use, there is no single mesh appropriate for every surgery. Furthermore, due to the risk of complications including acute and chronic infection, mesh shrinkage, and erosion of the tissue, the benefits of the use of meshes have recently been questioned. The aim of this work is to review the evolution of POP surgery, analyzing the current challenges, and detailing the key factors pertinent to the design of new mesh systems. Starting with a description of the pelvic floor anatomy, the article then presents the traditional treatments used in pelvic organ disorders. Next, the development of synthetic meshes is described with an insight into how their function is dependent on both mesh design variables (i.e., material, structure, and functional treatment) and surgical applications. These are then linked to common mesh‐related complications, and an indication of current research aiming to address these issues.

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“…Very large incisions or complex abdominal hernias are still a perplexing problem in patients with major risks of wound infections, and this has led to the development of prosthetic meshes, which have been in use since 1891 . Since the first mesh was developed, there has been great advances in this field aiming to reduce the occurrence of postoperative infection, hernias, and mesh rejections …”

Section: Introductionmentioning

confidence: 99%

“…9 Since the first mesh was developed, there has been great advances in this field aiming to reduce the occurrence of postoperative infection, hernias, and mesh rejections. 10 The ideal prosthetic mesh should be durable, non-carcinogenic, inert, non-immunogenic, and non-biodegradable whilst the wound heals. 10 Most current prosthetic meshes encompass all these properties; however, there is a subset of patients who experience wound dehiscence, leading to controversy as to whether it is the mesh that has caused the problems or if it is a measure of the failure of the surgical procedure.…”

mentioning

confidence: 99%

“…10 The ideal prosthetic mesh should be durable, non-carcinogenic, inert, non-immunogenic, and non-biodegradable whilst the wound heals. 10 Most current prosthetic meshes encompass all these properties; however, there is a subset of patients who experience wound dehiscence, leading to controversy as to whether it is the mesh that has caused the problems or if it is a measure of the failure of the surgical procedure. 11 The underlying cause and mechanisms as to why the mesh is being rejected in certain patients are still widely unknown.…”

mentioning

confidence: 99%

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The use of prosthetic mesh for abdominal wall repairs: A semi‐systematic‐literature review

Wales

Holloway

2018

International Wound Journal

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Following abdominal wall surgery, incisions are commonly sutured, stapled, or glued together by primary intention. Developments within the field of tissue engineering have led to the use of prosthetic meshes, with over 20 million meshes implanted each year worldwide. The function of the mesh is to hold together abdominal wall incisions and repair abdominal hernias. This has been demonstrated to be highly effective in some individuals; however, some patients have experienced postoperative complications, including dehiscence with further abdominal herniation (viscera protruding through the abdominal wall). Little is currently known about why these complications occur in a subset of patients who have had prosthetic mesh implants in abdominal wall repairs; therefore, this literature review examined existing studies identified via six electronic databases. A total of 463 studies were identified, of which 13 were included in this review. The results identified that the prosthetic mesh is highly successful in a large proportion of patients who have had a had a hernia repair in a range of locations; however, the prosthetic mesh has long-term complications, with rejection being observed in a subset of patients. The reason why the prosthetic is being rejected is still largely unknown, and therefore, further investigation needs to be carried out.

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Biomaterials in urinary incontinence and treatment of their complications

Cited by 17 publications

References 66 publications

Para-Urethral Injections with Urolastic® for Treatment of Female Stress Urinary Incontinence: Subjective Improvement and Safety

Para-Urethral Injections with Urolastic® for Treatment of Female Stress Urinary Incontinence: Subjective Improvement and Safety

The use of polymeric meshes for pelvic organ prolapse: Current concepts, challenges, and future perspectives

The use of prosthetic mesh for abdominal wall repairs: A semi‐systematic‐literature review

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