Synthetic biomaterials for pelvic floor reconstruction

Karlovsky, Matthew E.; Kushner, Leslie; Badlani, Gopal H.

doi:10.1007/s11884-006-0013-5

Cited by 5 publications

(6 citation statements)

References 54 publications

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“…An ideal candidate for a pelvic reconstructive material should be sterile, durable, non-carcinogenic, inexpensive, non-reactive to antigen, and resistant to body tissue remodeling [12,27]. However, there is currently no material matching such requirements.…”

Section: Discussionmentioning

confidence: 99%

Histological response to and immunogenicity of different material patches implanted in rabbit abdominal walls

Fan

Xu²,

Wang³

et al. 2013

Biomedizinische Technik/Biomedical Engineering

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The high failure rate of traditional procedures of repairing pelvic organ prolapse by using sutures pushes multiple transvaginal mesh delivery systems into the marketplace; however, these are currently without optimal clinical results. We observed the short-term histological changes and the effects of Th1/Th2 cytokines after the implantation in rabbit abdominal walls of five materials, i.e., porcine urinary bladder matrix (UBM), cross-linked UBM, polypropylene mesh, composite cross-linked UBM, and composite UBM, and explored the feasibility of their application to pelvic reconstructive surgery. Grafts were harvested at 1, 2, 4, 8, and 12 weeks after surgery and were processed for histology in order to evaluate the host inflammatory response and the degree of tissue incorporation. Additionally, graft site cytokine levels were determined by reverse transcriptase polymerase chain reaction. The results demonstrate that the two composite groups were associated with an erosion response, whereas the other groups induced a milder response than the composite groups. The Th1/Th2 cytokine mRNA expression levels of the cross-linked UBM group at each time point were similar to that of the sham group, whereas the other groups elicited a more variable expression. The cross-linked UBM showed slow degradation, mild inflammatory response, and low immunogenicity. This suggests that cross-linked UBM is a better material of choice for pelvic reconstructive surgery.

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Section: Discussionmentioning

confidence: 99%

Histological response to and immunogenicity of different material patches implanted in rabbit abdominal walls

Fan

Xu²,

Wang³

et al. 2013

Biomedizinische Technik/Biomedical Engineering

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“…It has been suggested in the literature that biochemical alterations in the type and quantity of these materials may act as contributing factors in pelvic floor dysfunction and SUI [7]. In one study, women with SUI, compared to normal women, exhibited higher concentrations of matrix metalloproteinases and lower concentrations of inhibitors of collagen breakdown in peri-urethral vaginal wall tissue.…”

Section: Why Synthetic Mesh?mentioning

confidence: 99%

“…These products are constructed by a similar knitting mechanism compared to monofilamentous lattices; however, secondary to the 10-micron interstices of polyfilament materials, the host tissue has decreased access for in-growth [7]. This also may have implications for macrophage infiltration and the prevention of mesh infections.…”

Section: Mesh Construction Modalitymentioning

confidence: 99%

The use of synthetic sub-urethral slings in the treatment of female stress urinary incontinence

Feifer

Corcos

2007

Int Urogynecol J

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We set out to review the existing literature regarding the use of synthetic suburethral sling products for the treatment of female stress urinary incontinence. Products currently implanted are examined and scrutinized, and evidence regarding their efficacy and complication rates is noted. Additionally, specifics of presently utilized synthetic materials, including construction method and biocompatibility, are explored and directly correlated to currently marketed products. This investigation was undertaken with the use of the Medline database. Studies pertaining to synthetic or surgical mesh, as well as each specific suburethral sling product, are included. Our findings and ultimately our recommendations stem from the preponderance of evidence supporting the continued use of knitted, macroporous polypropelene mesh slings. Several existing marketed products detailed in the study fit this description. Specific reference is made to recent reports of vaginal erosions and deep space infections related to several specific products. A cautionary note is also made regarding the implantation of transobturator sling products currently marketed without the necessary pre-market testing, potentially placing the public at risk. From the currently available literature on biomaterials, it seems clear that knitted macroporous polypropylene is the material of choice for suburethral implantation. With respect to the means and techniques by which these mesh materials are suburethrally implanted, the surgeon's choice often dictates which method is used, but recent experience has demonstrated that the transobturator approach can be equally as effective as the traditional tension-free vaginal tape, with less-associated morbidity. Ongoing randomized controlled trials will further clarify and distinguish between methods.

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“…Clearly, there is a need for development of new mesh technology that can combine the advantages of both natural and synthetic biomaterials. The model product should be able to maintain mechanical strength over time, enhance tissue repair, and be biocompatible and easily customizable for individual patients [18]. While some efforts have been made to produce hybrid biomaterials that utilize synthetic and natural substances [19,20], further studies into designing an ideal biomaterial are required.…”

Section: Commentsmentioning

confidence: 99%

The Scientific Rationale for Using Biomaterials in Stress Urinary Incontinence and Pelvic Organ Prolapse

Keys

Badlani

2011

Curr Urol Rep

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Synthetic biomaterials for pelvic floor reconstruction

Cited by 5 publications

References 54 publications

Histological response to and immunogenicity of different material patches implanted in rabbit abdominal walls

Histological response to and immunogenicity of different material patches implanted in rabbit abdominal walls

The use of synthetic sub-urethral slings in the treatment of female stress urinary incontinence

The Scientific Rationale for Using Biomaterials in Stress Urinary Incontinence and Pelvic Organ Prolapse

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