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Immunochemical and urodynamic outcomes after polypropylene mesh explant from the pelvic wall of rats

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Abstract

Introduction and hypothesis

To analyze the immunochemical and urodynamic outcomes after partial versus complete excision of transvaginal polypropylene mesh (PPM) from pelvic walls of rats.

Methods

Forty-eight female Sprague-Dawley (SD) rats were randomly distributed into seven groups: control, mesh total removal 60 days (M-T 60D), mesh total removal 180 days (M-T 180D), mesh partial removal 60 days (M-H 60D), mesh partial removal 180 days (M-H 180D), sham 60 days (Sham 60D), and sham 180 days (Sham 180D). In the mesh groups, PPM was inserted and partially (0.3 × 0.3 cm) or completely removed 30 days later. In the Sham group, the space between the vagina and bladder was dissected without placing or removing the synthetic mesh at day 1 and day 30 later. Urodynamic studies, immunochemical analysis, and Western blot were done at days 60 and 180.

Results

The M-T 60D voiding pressure was significantly decreased compared to the Sham 60D and M-H 60D. The voiding interval of M-T 60D was significantly shorter than that of M-H 60D. In the M-T 60D and M-T 180D groups, the leak point pressure was significantly less than in their corresponding sham groups. IL-1 and TNF-α were significantly more intense in M-T 60D compared to M-H 60D and Sham 60D. NGF was significantly greater in M-T 60D compared to Sham 60D. There were no significant differences in MMP-2 and CD-31s throughout the group.

Conclusion

Total mesh excision incites a host inflammatory response and transitory lower urinary tract dysfunction. Despite the good outcomes after total excision, the invasiveness and surgical risk associated with repeated procedures should not be underestimateded.

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Authors and Affiliations

  1. Division of Urogynecology, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Medical Center, 5, Fu-Hsin Street, Kwei-shan, Tao-Yuan City, Taiwan, 333, Republic of China

    Tsia-Shu Lo, Yi-Hao Lin, Ting-Xuan Huang & Hsiao-Chien Chu

  2. Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Keelung Medical Center, Keelung, Taiwan, Republic of China

    Tsia-Shu Lo & Yi-Pin Chen

  3. Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Taipei Medical Center, Taipei, Taiwan, Republic of China

    Tsia-Shu Lo

  4. Chang Gung University, School of Medicine, Taoyuan, Taiwan, Republic of China

    Tsia-Shu Lo & Yi-Hao Lin

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  1. Tsia-Shu Lo
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  2. Yi-Hao Lin
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  4. Hsiao-Chien Chu
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Correspondence to Tsia-Shu Lo.

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This study was supported by Chang Gung University Hospital research grant CMRPG2H0281.

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Lo, TS., Lin, YH., Huang, TX. et al. Immunochemical and urodynamic outcomes after polypropylene mesh explant from the pelvic wall of rats. Int Urogynecol J 33, 1839–1848 (2022). https://doi.org/10.1007/s00192-021-04842-7

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  • DOI: https://doi.org/10.1007/s00192-021-04842-7

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