Evaluation of xenogenic extracellular matrices as adjuvant scaffolds for the treatment of stress urinary incontinence

Abstract

This is the first comparative study on porcine UBM, porcine SIS, and synthetic polypropylene as adjuvant scaffolds for the treatment of SUI. Our results demonstrate that porcine UBM may provide an attractive alternative owing to its superior remodelling potential.

Development of Enzymatic-Resistant and Compliant Decellularized Extracellular Matrixes via Aliphatic Chain Modification for Bladder Tissue Engineering

“…Decellularized extracellular matrixes (dECMs) possess inherent predefined mechanical properties that may not match the mechanical requirements of the host tissue. − ,− For example, the rabbit bladder undergoes 125% elongation at an applied stress of only 0.35 MPa, while one of the most utilized dECMs in urinary tissue engineering, dSIS, undergoes 100% elongation at 6.5 MPa. We, therefore, aimed to address the mechanical requirement of high compliance (high extensibility at low applied stress) to approximate the large-deforming urinary bladder tissue by developing dECMs that undergo high elongation at a lower applied force.…”

“…However, these biomaterials lack bioactive factors and showed limited success in large-deforming load-bearing tissues. ,, In contrast, decellularized extracellular matrixes (dECMs) are considered advantageous due to the presence of growth factors and proteoglycans, which can stimulate tissue regrowth in vivo . ,− A variety of dECMs are currently used and approved by the Food and Drug Administration (FDA) as medical devices for soft tissue regeneration and some urologic surgeries, including small intestinal submucosa (SIS), bovine pericardium (BP), and urinary bladder matrix (UBM). − However, inconsistent preclinical and clinical success has impeded their usage as the gold standard of care. Many researchers employed dECMs to successfully regenerate urothelium, muscle layers, and complete vascularization in preclinical models, while others reported graft contracture, inflammation, and urine leakage. ,,,, These complications are attributed to poor distensibility and rapid scaffold degradation before urothelium regeneration. , Efforts to alter material properties through chemical cross-linkers caused increased immunogenicity and reduced scaffold elasticity, making it unsuitable for bladder tissue function. − Next-generation biomaterials are being further developed, including coating dECMs with synthetic polymers and incorporating nanoparticles and growth factors. − …”

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

“…Fibroblast isolation and culture were performed by methods previously described by Davis et al [ 22 ]. All chemical reagents were obtained from Sigma-Aldrich® unless indicated.…”

“…Cell seeding was performed as previously described by Davis et al [ 22 ]. HUFs were cultured onto PP, PCL, the composite and PD.…”

Mechanical characterization of a biodegradable mesh for the treatment of stress urinary incontinence

“…At present, a “pause” is in effect in the UK and Ireland on the use of synthetic PP mesh for both POP and SUI surgery 4,5 . This has led to the investigation of biodegradable materials for SUI surgery 6,7 . The ideal material should elicit a controlled M2 macrophage response, which allows ECM production, angiogenesis and fibroblast ingrowth 8 .…”