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Characterizing the ex vivo textile and structural properties of synthetic prolapse mesh products

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Abstract

Introduction and hypothesis

The use of polypropylene meshes for surgical repair of pelvic organ prolapse (POP) has been limited by complications, including mesh exposure, encapsulation, and pain. Numerous products are available with a wide array of textile and structural properties. It is thought that complications may be related, in part, to mesh structural properties. However, few descriptions of these properties exists to directly compare products. The aim of this study was to determine the textile and structural properties of five commonly used prolapse mesh products using a ball-burst failure protocol.

Methods

Porosity, anisotropic index, and stiffness of Gynemesh PS (n = 8), the prototype polypropylene mesh for prolapse repair, was compared with four newer-generation mesh produces: UltraPro (n = 5), SmartMesh (n = 5), Novasilk (n = 5), and Polyform (n = 5).

Results

SmartMesh was found to be the most porous, at 78 % ± 1.4 %. This value decreased by 21 % for Gynemesh PS (p < 0.001), 14 % for UltraPro and Novasilk (p < 0.001), and 28 % for Polyform (p < 0.001). Based on the knit pattern, SmartMesh and Polyform were the only products considered to be geometrically isotropic, whereas all other meshes were anisotropic. Comparing the structural properties of these meshes, Gynemesh PS and Polyform were the stiffest: 60 % and 42 % stiffer than SmartMesh (p < 0.001) and Novasilk (p < 0.001), respectively. However, no significant differences were found between these two mesh products and UltraPro.

Conclusions

Porosity, anisotropy, and biomechanical behavior of these five commonly used polypropylene mesh products were significantly different. This study provides baseline data for future implantation studies of prolapse mesh products.

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Acknowledgements

National Institutes of Health (NIH) Support R01 HD061811-01

Conflicts of Interest

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Authors and Affiliations

  1. Musculoskeletal Research Center, Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA

    Andrew Feola & William Barone

  2. Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics, Gynecology, and Reproductive Sciences, Magee-Womens Hospital, Magee-Womens Research Institute, University of Pittsburgh, Pittsburgh, PA, USA

    Pamela Moalli

  3. Musculoskeletal Research Center and Magee-Womens Research Institute, Departments of Bioengineering and Obstetrics, Gynecology, Reproductive Sciences University of Pittsburgh, Pittsburgh, PA, USA

    Steven Abramowitch

  4. Musculoskeletal Research Center, Department of Bioengineering, University of Pittsburgh, 405 Center for Bioengineering, 300 Technology Drive, Pittsburgh, PA, 15219, USA

    Steven Abramowitch

Authors
  1. Andrew Feola
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  2. William Barone
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  3. Pamela Moalli
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  4. Steven Abramowitch
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Correspondence to Steven Abramowitch.

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Feola, A., Barone, W., Moalli, P. et al. Characterizing the ex vivo textile and structural properties of synthetic prolapse mesh products. Int Urogynecol J 24, 559–564 (2013). https://doi.org/10.1007/s00192-012-1901-1

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  • DOI: https://doi.org/10.1007/s00192-012-1901-1

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