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International Urogynecology Journal

Published in:

01-07-2009 | Original Article

Tensile properties of commonly used prolapse meshes

Authors: Keisha A. Jones, Andrew Feola, Leslie Meyn, Steven D. Abramowitch, Pamela A. Moalli

Published in: International Urogynecology Journal | Issue 7/2009

Abstract

Introduction and hypothesis

To improve our understanding of the differences in commonly used synthetic prolapse meshes, we compared four newer generation meshes to Gynecare PS™ using a tensile testing protocol. We hypothesize that the newer meshes have inferior biomechanical properties.

Methods

Meshes were loaded to failure (n = 5 per group) generating load–elongation curves from which the stiffness, the load at failure, and the relative elongation were determined. Additional mesh samples (n = 3) underwent a cyclic loading protocol to measure permanent elongation in response to subfailure loading.

Results

With the exception of Popmesh, which displayed uniform stiffness, other meshes were characterized by a bilinear behavior. Newer meshes were 70–90% less stiff than Gynecare™ (p < 0.05) and more readily deformed in response to uniaxial and cyclical loading (p < 0.001).

Conclusion

Relative to Gynecare™, the newer generation of prolapse meshes were significantly less stiff, with irreversible deformation at significantly lower loads.

Pulliam SJ, Ferzandi TR, Hota LS, Elkadry EA et al (2007) Use of synthetic Mesh in pelvic reconstructive surgery: a survey of attitudes and practice pattern of urogynecologists. Int Urogynecol J 11:1–9

Nygaard IE, McCreery R, Brubaker L, Connolly A Cundiff G, Weber AM, Zyczynski H, Pelvic Floor Disorders Network (2004) Abdominal sacrocolpopexy: a comprehensive review. Obstet Gynecol 104:805–823PubMed

Nicita G (1998) A new operation for genitourinary prolapse. J Urol 160:741–745PubMedCrossRef

Floof CG, Drutz HP, Waja L (1998) Anterior colporrhaphy reinforced with Marlex. Mesh for treatment of cystocele. Int Urogynecol J Pelvic Floor Dysfunct 9:200–2004CrossRef

Jameson JS, Chia YW, Kamm MA et al (1994) Effects of age, sex, and parity on anorectal function. Br J Surg 81:1689–1692PubMedCrossRef

Jones NHJ, Healy JC, King LJ (2003) Pelvic Connective Tissue resilience decreases with vaginal delivery, menopause and uterine prolapse. Br J Surg 90:466–472CrossRef

Olsen AL, Smith VJ, Bergstom JO et al (1997) Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol 89:501–506PubMedCrossRef

Chen CG, Ridgeway B, Paraiso MF (2007) Biologic grafts and Synthetic meshes in pelvic reconstructive Surgery. Clin Obstet and Gynecol 50(2):383–411CrossRef

Dora C, Dimarco D, Zobitz M, Elliot D (2004) Time dependent variations in biomechanical properties of cadaveric fascia, porcine dermis, porcine small intestine submucosa, polypropylene mesh and autologous fascia in the rabbit model: implication for sling surgery. J Urol 171:1970–1973PubMedCrossRef

10.

Fenner DE (2000) New surgical mesh. Clin Obstet Gynecol 43:647–652CrossRef

11.

Amrute K, Badlani G (2006) Female incontinence: a review of biomaterials and minimally invasive techniques. Current Opinion Urol 16:54–59CrossRef

12.

Cosson M, Debodinance P, Boukerrou M, Chauvet MP, Lobry P, Crepin G, Ego A (2003) Mechanical properties of synthetic implants used in repair of prolapse and urinary incontinence in women: which is the ideal material. Int Urogynecol J 14:169–178CrossRef

13.

Amid PK (1997) Classification of biomaterials and their related complications in abdominal wall surgery. Hernia 1:15–21CrossRef

14.

Moalli PM, Papas N, Menefee S Abramowitch S (2008) Tensile properties of six commonly used mid-urethral slings. Int Urogynecol J 19:655–663CrossRef

15.

Kohli N, Walsh PM, Roat TW, Karram MM (1998) Mesh erosion after abdominal sacrocolpopexy. Obstet Gynecol 92:999–1004PubMedCrossRef

16.

Mistrangelo E, Mancuso S, Nadalini C, Lijoi D, Costantini L (2007) Rising use of synthetic mesh in transvaginal pelvic reconstructive surgery: A review of risk of vaginal erosion. J Minim Invasive Gynecol 14:564–569PubMedCrossRef

17.

Huebner M, Fenner DE (2006) The use of graft material in vaginal pelvic floor surgery. Int J Obstet Gynecol 92:279–288CrossRef

18.

Isom-Batz G, Zimmern PE (2007) Vaginal mesh for incontinence and/or prolapse: caution required!. Expert Rev Med Devices 4:675–679PubMedCrossRef

Title: Tensile properties of commonly used prolapse meshes
Authors: Keisha A. Jones
Andrew Feola
Leslie Meyn
Steven D. Abramowitch
Pamela A. Moalli
Publication date: 01-07-2009
Publisher: Springer-Verlag
Published in: International Urogynecology Journal / Issue 7/2009
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-008-0781-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Tensile properties of commonly used prolapse meshes

Abstract

Introduction and hypothesis

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction and hypothesis

Methods

Results

Conclusion

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