The immunohistochemical and urodynamic evaluation towards the collagen-coated and non-coated polypropylene meshes implanted in the pelvic wall of the rats

Abstract

Our aim is to study the inflammatory response towards the collagen-coated and non-coated polypropylene meshes in rats and the urodynamic investigation post-operatively. Forty-two female Sprague Dawley were divided into 7 groups of 6 rats; Control, Day 7 and 30 for Sham, Avaulta Plus (MPC), Perigee (MP). UDS were taken at days 7 and 30. Mesh with the vagina and bladder wall was removed and sent for immunohistochemical examination. Results showed intense inflammatory reaction on day 7 in the study groups which decreased on day 30. IL-1, TNF-α, MMP-2 and CD31 were observed to decrease from day 7 to day 30. NGF was almost normal on day 30 in all groups. UDS showed no difference in voiding pressure. Both Study and Sham groups had shorter voiding interval (VI) on day 7 but significantly lower in MPC. VI had significantly increased on day 30 in all groups. Voided volume was significantly lower in the mesh groups even when an increase was seen on day 30. In conclusion, the higher levels of IL-1, TNF-α and MMP-2 in collagen-coated polypropylene mesh imply greater inflammation than the non-coated polypropylene mesh. Mesh implantation can lead to shorter voiding interval and smaller bladder capacity.

The impact of bacterial contamination on the host response towards fully absorbable poly-4-hydroxybutyrate and nonabsorbable polypropylene pelvic floor implants

“…Extensive histological analysis revealed higher levels of inflammatory cell infiltration, vascularization, and FBGC formation in mice with a biomaterial as compared to sham mice, confirming previous observations [ [42] , [43] , [44] , [45] , [46] ]. It is known that denser implants with smaller pores induce a more pronounced or prolonged inflammatory response as compared to lighter implants with larger pores [ 47 ].…”

Managing female pelvic floor disorders: a medical device review and appraisal

“…Across studies, implantation of polypropylene mesh in the rabbit vagina demonstrated mild inflammation and positive signs of mesh incorporation, including infiltrating smooth muscle bundles, blood vessels and connective tissue [32,131]. In two rodent models and a rabbit model, polypropylene implantation between the vagina and the bladder led to an acute inflammatory response at 7 days that fell at later time points [132][133][134]. In rabbits, the inflammatory response was significantly increased in vaginally implanted mesh compared with abdominally implanted mesh, underscoring the differences in biocompatibility between these locations [32].…”

Methacrylic Acid Copolymer Coating Enhances Constructive Remodeling of Polypropylene Mesh by Increasing the Vascular Response

“…To tackle this problem, the tissue response to the implanted material has to be directed toward a more regenerative pathway, also called constructive remodeling, where the foreign body response leads to restitution of normal tissue rather than excess fibrosis. A variety of biological coatings have been proposed to modulate the tissue response to mesh, including collagen, mesenchymal stromal cells, porcine dermal and bladder extracellular matrix, or macrophage polarizing cytokines . However, the addition of biologics or therapeutic drugs to these medical devices can be cumbersome, shorten shelf life and complicate the device's regulatory pathway.…”