Development and in vitro investigation of a biodegradable mesh for the treatment of stress urinary incontinence

Abstract

Introduction and hypothesis The use of polypropylene (PP) mesh for stress urinary incontinence (SUI) surgery has declined because of safety concerns. The aim of this study is to evaluate a biodegradable polycaprolactone (PCL) mesh and a PCL composite mesh tissue engineered with human uterine fibroblasts (HUFs) for SUI surgery by comparing mechanical properties and in vitro biocompatibility to commercially available PP and porcine dermis (PD). Methods The mechanical properties of four scaffold materials were evaluated: PCL, PCL-collagen-hyaluronic acid composite, acellular porcine dermal collagen (PD) (Pelvicol™) and polypropylene (Gynecare TVT™ Exact®). HUFs were seeded on separate scaffolds. After 7 and 14 days scaffolds were assessed for metabolic activity and cell proliferation using Alamar Blue, Live/Dead and PicoGreen assays. Soluble collagen production was evaluated using a Sircol assay. Results PCL and the composite scaffold reached ultimate tensile strength (UTS) values closest to healthy pelvic floor tissue (PCL = 1.19 MPa; composite = 1.13 MPa; pelvic floor = 0.79 MPa; Lei et al. Int Urogynecol J Pelvic Floor Dysfunct. 18(6):603-7, 2007). Cells on PCL showed significantly greater cell viability than PP at day 7 (p < 0.0001). At D14 the composite scaffold showed significantly greater cell viability than PP (p = 0.0006). PCL was the best performing scaffold for soluble collagen production at day 14 (106.1 μg versus 13.04 μg for PP, p = 0.0173). Conclusions We have designed a biodegradable PCL mesh and a composite mesh which demonstrate better biocompatibility than PP and mechanical properties closer to that of healthy pelvic floor tissue. This in vitro study provides promising evidence that these two implants should be evaluated in animal and human trials.

Development of a 3D-printed bioabsorbable composite scaffold with mechanical properties suitable for treating large, load-bearingarticular cartilage defects

“…An effective reinforcing structure for a natural ECM-based matrix, such as the CHyA scaffold, must also increase its tensile modulus to ensure it can be fixed effectively to the subchondral bone within a chondral defect. To accomplish this, PCL was selected as the biodegradable/bioabsorbable thermopolymer to create reinforced matrices due to its suitable mechanical properties, degradation profile, use in prior FDA-approved devices and compatibility with 3D printing (Chang et al, 2018;Hutmacher et al, 2001;MacCraith et al, 2022;Moers-Carpi et al, 2013;Zhang et al, 2018). Utilising 3D printing to deposit PCL in the biofabrication process, with spatial precision, allows scaffold designs to undergo iterative progressions to better elucidate how design criteria affect mechanical properties, allowing specific optimisation for the repair of large-area chondral defects.…”