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Published in: International Urogynecology Journal 8/2022

Open Access 21-03-2022 | Stress Incontinence | Original Article

Development and in vitro investigation of a biodegradable mesh for the treatment of stress urinary incontinence

Authors: E. MacCraith, M. Joyce, R. J. F. C. do Amaral, F. J. O’Brien, N. F. Davis

Published in: International Urogynecology Journal | Issue 8/2022

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Abstract

Introduction and hypothesis

The use of polypropylene (PP) mesh for stress urinary incontinence (SUI) surgery has declined because of safety concerns. The aim of this study is to evaluate a biodegradable polycaprolactone (PCL) mesh and a PCL composite mesh tissue engineered with human uterine fibroblasts (HUFs) for SUI surgery by comparing mechanical properties and in vitro biocompatibility to commercially available PP and porcine dermis (PD).

Methods

The mechanical properties of four scaffold materials were evaluated: PCL, PCL-collagen-hyaluronic acid composite, acellular porcine dermal collagen (PD) (Pelvicol™) and polypropylene (Gynecare TVT™ Exact®). HUFs were seeded on separate scaffolds. After 7 and 14 days scaffolds were assessed for metabolic activity and cell proliferation using Alamar Blue, Live/Dead and PicoGreen assays. Soluble collagen production was evaluated using a Sircol assay.

Results

PCL and the composite scaffold reached ultimate tensile strength (UTS) values closest to healthy pelvic floor tissue (PCL = 1.19 MPa; composite = 1.13 MPa; pelvic floor = 0.79 MPa; Lei et al. Int Urogynecol J Pelvic Floor Dysfunct. 18(6):603-7, 2007). Cells on PCL showed significantly greater cell viability than PP at day 7 (p < 0.0001). At D14 the composite scaffold showed significantly greater cell viability than PP (p = 0.0006). PCL was the best performing scaffold for soluble collagen production at day 14 (106.1 μg versus 13.04 μg for PP, p = 0.0173).

Conclusions

We have designed a biodegradable PCL mesh and a composite mesh which demonstrate better biocompatibility than PP and mechanical properties closer to that of healthy pelvic floor tissue. This in vitro study provides promising evidence that these two implants should be evaluated in animal and human trials.
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Metadata
Title
Development and in vitro investigation of a biodegradable mesh for the treatment of stress urinary incontinence
Authors
E. MacCraith
M. Joyce
R. J. F. C. do Amaral
F. J. O’Brien
N. F. Davis
Publication date
21-03-2022
Publisher
Springer International Publishing
Published in
International Urogynecology Journal / Issue 8/2022
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-022-05160-2

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