Polypropylene mesh and the host response

Patel, Hiren; Ostergard, Donald R.; Sternschuss, Gina

doi:10.1007/s00192-012-1718-y

Cited by 83 publications

(82 citation statements)

References 80 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This is consistent with what occurs after implantation of a biomedical device and is referred to as the "foreign body reaction" [15]. This is an immunologically mediated process that takes place at the cellular level and initially occurs during the first few weeks following implantation, but remains present at the device/host-tissue level for a lifetime depending on what kind of biomaterial is used [20].…”

Section: Discussionsupporting

confidence: 60%

“…Of the four types of mesh in this classification system, polypropylene mesh, which is used in most midurethral slings, is classified as a type 1 mesh and contains many of the desirable properties listed above. The host response to polypropylene mesh has been described in human and animal models [15]; however, the response in the human vagina has not been well studied.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Histopathology of excised midurethral sling mesh

et al. 2014

View full text Add to dashboard Cite

show abstract

Section: Discussionsupporting

confidence: 60%

Section: Discussionmentioning

confidence: 99%

Histopathology of excised midurethral sling mesh

et al. 2014

View full text Add to dashboard Cite

show abstract

“…253 Several studies have confirmed this finding, noting that the assumption that mesh is widely considered to be biologically inert is based on results of short-term animal experiments without corroborating studies in humans. [342][343][344] At present, general human tissue inter actions with the mesh are known, but we have an incomplete understanding of interactions specific to a mesh material and design as well as the pathophysiology of any complications.…”

Section: Mesh-body Interactionsmentioning

confidence: 99%

“…345,346 However, only since the 1990s have tissue-implant interactions been studied, and, to date, few reports of the mechanisms involved have been published. [342][343][344] Immediately after implantation, foreign bodies, including modern implantable polymers, become coated with proteins followed by the appearance of inflammatory cells that migrate into the tissue, owing to the action of inflammatory mediators. 347,348 As in any tissue injury, the acute phase of inflammation is characterized by the appearance of short-lived neutrophils.…”

Section: Inflammatory Reactionsmentioning

confidence: 99%

Safety considerations for synthetic sling surgery

et al. 2015

View full text Add to dashboard Cite

Implantation of a synthetic midurethral sling (SMUS) is the most commonly performed anti-incontinence operation in women worldwide. The effectiveness of the SMUS is comparable to that of the historical gold standards--autologous fascial slings and the Burch colposuspension. Much controversy, however, has evolved regarding the safety of this type of sling. Overall, the quality of the studies with respect to assessing risks of SMUS-associated complications is currently poor. The most common risks in patients with SMUS include urethral obstruction requiring surgery (2.3% of patients with SMUS), vaginal, bladder and/or urethral erosion requiring surgery (1.8%) and refractory chronic pain (4.1%); these data likely represent the minimum risks. In addition, the failure rate of SMUS implantation surgery is probably at least 5% in patients with stress urinary incontinence (SUI). Furthermore, at least one-third of patients undergoing sling excision surgery develop recurrent SUI. Considering the additional risks of refractory overactive bladder, fistulas and bowel perforations, among others, the overall risk of a negative outcome after SMUS implantation surgery is ≥15%.

show abstract

“…3 When used as a mechanical reinforcement in functional muscle repair, a synthetic mesh is intended to serve as a permanent implant, which remains in the patient for life. 4,5 A synthetic mesh, such as polypropylene mesh (PPM), is widely used due to its high strength. However, although the use of synthetic mesh materials significantly reduces recurrence rates by providing strong mechanical support to the abdominal wall or pelvic floor, commonly used synthetic polymers can sometimes elicit a strong foreign body reaction, often resulting in fibrous tissue encapsulation, erosion, or mesh degradation with high infection rates.…”

mentioning

confidence: 99%