Do preoperative cytokine levels offer a prognostic factor for polypropylene mesh erosion after suburethral sling surgery for stress urinary incontinence?

Abstract

When polypropylene meshes are used in reconstructive urogynecological surgery, the erosion rates vary from 3.3% to 14% and causative factors for such erosions are still unknown in many cases. Therefore, the aim of our study was to establish the role of immunologic factors in the process of polypropylene tapes erosions after suburethral sling procedures. Serum concentrations of tumor necrosis factor alpha, interleukin (IL)-2, IL-4, IL-5, IL-10, and interferon (IFN)-gamma were estimated in 123 patients suffering from stress urinary incontinence preoperatively and during 12 months follow-up using Human Th1/Th2 Cytokine Cytometric Bead Array I kit. The same immunological assessment was performed in each case of detected tape erosion. Statistical calculation was performed using UNIVARIATE, CORR, and NPAR1WAY procedures from Statistical Analysis System. The unpaired Student's t test, nonparametric Mann-Whitney U test, and Wilcoxon tests were used. Preoperative IFN-gamma concentration was significantly higher in women with subsequent polypropylene mesh erosion when compared to women with successful outcome (p < 0.05). Th1 cytokine profile may be related to the risk of the vaginal erosions following placement of polypropylene meshes. The way to lower erosion rate may involve exclusion of the patients immunologically prone to synthetic material erosion. The factor which can help to select such patients could be preoperative level of IFN-gamma.

Migration of extraluminal tracheal ring prostheses after tracheoplasty for treatment of tracheal collapse in a dog

“…Polypropylene mesh implants are commonly used in human reconstructive surgery and result in implant-related erosions in 1% to 2% of cases. [4][5][6][7][8][9] Polypropylene implants induce a mild but persistent foreign body reaction in recipient tissues in multiple species, 9 so it is logical to assume that similar chronic foreign body reactions occur in dogs that receive polypropylene implants. Histologically, the mass removed from the tracheal lumen in the study reported here had features consistent with chronic inflammation and the tissue reaction induced by a foreign body.…”

Polypropylene mesh and the host response

“…Recently, Rechberger et al investigated the role between preoperative cytokine levels and PP mesh erosion after suburethral sling placement [24]. Preoperative serum IFN concentrations in a group of patients without mesh erosion were compared with preoperative levels for patients with mesh erosion.…”

Effect of platelet-rich plasma on polypropylene meshes implanted in the rabbit vagina: histological analysis

“…Rechberger et al observed that the serum levels of cytokines are higher in patients with erosion slings than in those with proper healing ( 5 ). Similarly, Di Vita et al demonstrated that the use of polypropylene for hernia repair is associated with high levels of interleukin-6 and interferon, when compared to traditional correction ( 6 ).…”