Animal models for pelvic organ prolapse: systematic review

Abstract

Introduction and hypothesis We aimed to summarize the knowledge on the pathogenesis of pelvic organ prolapse (POP) generated in animal models. Methods We searched MEDLINE, Embase, Cochrane and the Web of Science to establish what animal models are used in the study of suggested risk factors for the development of POP, including pregnancy, labor, delivery, parity, aging and menopause. Lack of methodologic uniformity precluded meta-analysis; hence, results are presented as a narrative review. Results A total of 7426 studies were identified, of which 51 were included in the analysis. Pregnancy has a measurable and consistent effect across species. In rats, simulated vaginal delivery induces structural changes in the pelvic floor, without complete recovery of the vaginal muscular layer and its microvasculature, though it does not induce POP. In sheep, first vaginal delivery has a measurable effect on vaginal compliance; measured effects of additional deliveries are inconsistent. Squirrel monkeys can develop POP. Denervation of their levator ani muscle facilitates this process in animals that delivered vaginally. The models used do not develop spontaneous menopause, so it is induced by ovariectomy. Effects of menopause depend on the age at ovariectomy and the interval to measurement. In several species menopause is associated with an increase in collagen content in the longer term. In rodents there were no measurable effects of age apart of elastin changes. We found no usable data for other species. Conclusion In several species there are measurable effects of pregnancy, delivery and iatrogenic menopause. Squirrel monkeys can develop spontaneous prolapse.

Tannic acid-loaded hydrogel coating endues polypropylene mesh with hemostatic and anti-inflammatory capacity for facilitating pelvic floor repair

“…The optimal POP animal models for POP should be squirrel monkeys and ewes [ 58–60 ], which could simulate the pathophysiology of humanity. However, abdominal defect models could be used as a POP model to evaluate the repair effects and host responses of implanted materials [ 22 , 60 , 61 ].…”

Endometrial SUSD2+ Mesenchymal Stem/Stromal Cells in Tissue Engineering: Advances in Novel Cellular Constructs for Pelvic Organ Prolapse

“…Anatomical, biomechanical, biochemical, and histological studies in nulliparous, primiparous, and multiparous ewes demonstrated similar rates of POP after vaginal delivery to that observed in humans, due to a large foetal head to body ratio and relatively comparable pelvic anatomy [ 88 , 89 ]. The diameter and length of the ovine and human vagina are relatively similar, and the ovine pelvic architecture relies on three levels of support, similar to the DeLancey model described in humans [ 90 , 91 ]. Both ovine and human vaginal wall consist of four histological zones of epithelium, lamina propria, muscularis, and adventitia [ 92 ].…”

Female squirrel monkeys as models for research on women’s pelvic floor disorders

“…A recent systematic review of the literature showed that several animal models have been used in the study of the pathophysiology of POP, such as lagomorphs, rodents, sheep, and NHPs. 50 The authors concluded that in several species there are measurable effects of pregnancy, delivery, and iatrogenic menopause, but there is not a single uniform pattern. However, only squirrel monkeys develop clinical POP spontaneously.…”