Comparison of candidate scaffolds for tissue engineering for stress urinary incontinence and pelvic organ prolapse repair

Abstract

Objectives• To identify candidate materials which have sufficient potential to be taken forward for an in vivo tissue-engineering approach to restoring the tissue structure of the pelvic floor in women with stress urinary incontinence (SUI) or pelvic organ prolapse (POP). Materials and Methods• Oral mucosal fibroblasts were seeded onto seven different scaffold materials, AlloDerm ( LifeCell Corp., Branchburg, NJ, USA), cadaveric dermis, porcine dermis, polypropylene, sheep forestomach, porcine small intestinal submucosa (SIS) and thermoannealed poly(L) lactic acid (PLA) under both free and restrained conditions. • The scaffolds were assessed for: cell attachment using AlamarBlue and 4,6-diamidino-2phenylindole (DAPI); contraction using serial photographs; and extracellular matrix production using Sirius red staining, immunostaining and scanning electron microscopy.• Finally the biomechanical properties of all the scaffolds were assessed. Results• Of the seven, there were two biodegradable scaffolds, synthetic PLA and natural SIS, which supported good cell attachment and proliferation.• Immunostaining confirmed the presence of collagen I, III and elastin which was highest in SIS and PLA.• The mechanical properties of PLA were closest to native tissue with an ultimate tensile strength of 0.72 Ϯ 0.18 MPa, ultimate tensile strain 0.53 Ϯ 0.16 and Young's modulus 4.5 Ϯ 2.9 MPa.• Scaffold restraint did not have a significant impact on the above properties in the best scaffolds. Conclusion• These data support both PLA and SIS as good candidate materials for use in making a tissue-engineered repair material for SUI or POP.

Induction of endometrial mesenchymal stem cells into tissue-forming cells suitable for fascial repair

“…Biodegradable poly-L-lactic acid scaffolds have been suggested as a putative candidate for delivering human oral FB or human adipose-derived stem cells for stress urinary incontinence and POP repair [29,30]. The present authors compared a set of new non-degradable meshes using a rat abdominal hernia model and found the implanted PA + G meshes were well-tolerated and biocompatible [20].…”

Mechanical stretching promotes the differentiation of BMSC into pelvic floor ligament fibroblasts

“…Ligament fibroblasts are the main component of pelvic connective tissue, and they are considered a contributing factor in PFD [2][3]. Moreover, these fibroblasts are capable of synthesizing and secreting ECM proteins (collagen, elastin, and amino chitosan), and they are responsive to mechanical force and play important roles in wound healing and tissue reconstruction [12].…”

“…Pelvic floor dysfunction (PFD), mainly including stress urinary incontinence (SUI), pelvic organ prolapse (POP), and fecal incontinence (FI), is common in women and more prevalent in the aging population [1][2][3]. PFD is a complex disease that involves many factors, and the majority of research suggests that the total collagen content is decreased in pelvic connective tissue and that the pelvic support tissues (the ligament, muscle and fascia) are relaxed because of reduced collagen fibers, which eventually leads to PFD [4,5].…”

Integration of nondegradable polystyrene and degradable gelatin in a core–sheath nanofibrous patch for pelvic reconstruction

“…An ideal pelvic patch should provide sufficient mechanical support to the pelvic floor and prevent pelvic organs from protruding into the vagina; meanwhile, the patch should not be too stiff so as to erode native tissues. 29 In order to evaluate the mechanical properties of the PS/gelatin, loadextension measurements were performed with a strain rate of 5 mm/min. The Young's modulus of gelatin/PS scaffold is 12.42±2.92 MPa, similar to that of the corresponding native tissues.…”