Tissue-engineered repair material for pelvic floor dysfunction

Abstract

Pelvic floor dysfunction (PFD) is a highly prevalent urogynecology disorder affecting many women worldwide, with symptoms including pelvic organ prolapse (POP), stress urinary incontinence (SUI), fecal incontinence, and overactive bladder syndrome (OAB). At present, the clinical treatments of PFD are still conservative and symptom-based, including non-surgical treatment and surgery. Surgical repair is an effective and durable treatment for PFD, and synthetic and biological materials can be used to enforce or reinforce the diseased tissue. However, synthetic materials such as polypropylene patches caused a series of complications such as mesh erosion, exposure, pain, and inflammation. The poor mechanical properties and high degradation speed of the biomaterial meshes resulted in poor anatomical reduction effect and limitation to clinical application. Therefore, the current treatment options are suboptimal. Recently, tissue-engineered repair material (TERM) has been applied to repair PFD and could markedly improve the prognosis of POP and SUI repair surgery in animal models. We review the directions and progression of TERM in POP and SUI repair. Adipose-derived stem cells (ADSCs) and endometrial mesenchymal stem cells (eMSCs) appear to be suitable cell types for scaffold seeding and clinical implantation. The multidisciplinary therapy approach to tissue engineering is a promising direction for tissue repair. More and longer follow-up studies are needed before determining cell types and materials for PFD repair.

RETRACTED ARTICLE: Retrospective study of preservation and transection of the round ligament of uterus during laparoscopic transabdominal preperitoneal inguinal hernia repair in adult women

“…It is the ideal body structure, and an intact set of round ligaments can be of great help in treatment of uterine prolapse. Although synthetic and biomaterials can be used in the treatment of pelvic floor dysfunction disorders, such as uterine prolapse, possibly they can lead to a series of serious complications such as polypropylene meshes that can lead to mesh erosion, exposure, pain and inflammation, while biopatches have poor mechanical properties and degrade rapidly, leading to poor anatomical reduction, which in turn limits their clinical use [ 22 ]. Hernia surgeons should be proactive in protecting the round ligament of uterus.…”

Preliminary study on mesenchymal stem cells in repairing nerve injury in pelvic floor denervation

“…The development of tissue engineering and regenerative medicine provides new possibilities for refractory degenerative diseases ( Ma et al, 2021 ). Considering the strong correlation between PFD and connective tissue injury, mesenchymal stem cells (MSCs) have great potential as seed cells ( Lin et al, 2022 ). Previous studies have confirmed its safety and possible effectiveness ( Mukherjee et al, 2019 ).…”

A novel 3D printed type II silk fibroin/polycaprolactone mesh for the treatment of pelvic organ prolapse

“…Their physical properties (e.g., porosity, mesh weight, and mechanical properties) and manufacturing processes are important regulatory bases for cell adhesion, tissue repair, and regeneration. 10 Preparation methods such as freeze drying, gas forming, solvent casting-particle leaching and electrostatic spinning have been used for the preparation of porous scaffolds with collagen, alginate, silk fibroin, and poly(lactic acid-co-glycolic acid) stent materials. [11][12][13] However, these methods are unable to control the microstructure of scaffolds.…”