Abstract
Introduction and hypothesis
A new type of resorbable biomaterial intended for pelvic reconstruction was tested with respect to tissue regeneration and biocompatibility in rats. The biomaterial consisted of methoxypolyethyleneglycol-poly(lactic-co-glycolic acid) (MPEG-PLGA). Implants were pure, enriched with extra-cellular matrix (ECM) or estrogen.
Methods
Ten implants of each type were tested for 3 and 8 weeks, respectively. Histological assessment of connective tissue organization, inflammation, vascularization, and thickness of regenerated tissue was undertaken.
Results
All implants had a high degree of biocompatibility. ECM-enriched implants had significantly higher inflammatory scores compared to pure implants at 3 weeks. At 8 weeks, neither of the parameters differed significantly. No trace of the implants remained.
Conclusions
The MPEG-PLGA is highly biocompatible, degrades quickly, and seems inert in the process of tissue regeneration. Thus, it is hardly a candidate per se in reinforcement of pelvic reconstruction, but it could have a future role as carrier for stem cells.
Similar content being viewed by others
Abbreviations
- POP:
-
Pelvic organ prolapse
- MPEG-PLGA:
-
Methoxypolyethyleneglycol-poly(lactic-co-glycolic acid)
- PLGA:
-
Polyglactin (poly(lactic-co-glycolic acid))
- ECM:
-
Extra-cellular matrix
References
Adekanmi OA et al (2009) Do the anatomical defects associated with cystocoele affect the outcome of anterior repair? A clinical and radiological study. Int Urogynecol J Pelvic Floor Dysfunct 20:1369–1377
Olsen AL, Smith VJ, Bergstrom JO, Colling JC, Clark AL (1997) Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol 89:501–506
Weber AM, Walters MD, Piedmonte MR, Ballard LA (2001) Anterior colporrhaphy: a randomized trial of three surgical techniques. Am J Obstet Gynecol 185:1299–1304
Jia X et al (2008) Efficacy and safety of using mesh or grafts in surgery for anterior and/or posterior vaginal wall prolapse: systematic review and meta-analysis. BJOG 115:1350–1361
Jones K, Feola A, Meyn L, Abramowitch S, Moalli P (2009) Tensile properties of commonly used prolapse meshes. Int Urogynecol J 20:847–853
Murphy M (2009) Use of mesh and materials in pelvic floor surgery. Obstet Gynecol Clin North Am 36:615–635
Blandon RE, Gebhart JB, Trabuco EC, Klingele CJ (2009) Complications from vaginally placed mesh in pelvic reconstructive surgery. Int Urogynecol J Pelvic Floor Dysfunct 20:523–531
Deprest J et al (2006) The biology behind fascial defects and the use of implants in pelvic organ prolapse repair. Int Urogynecol J 17:16–25
Baessler K, Maher CF (2006) Mesh augmentation during pelvic-floor reconstructive surgery: risks and benefits. Curr Opin Obstet Gynecol 18:560–566
Falconer C, Soderberg M, Blomgren B, Ulmsten U (2001) Influence of different sling materials on connective tissue metabolism in stress urinary incontinent women. Int Urogynecol J Pelvic Floor Dysfunct 12(Suppl 2):S19–S23
Kavvadias T, Kaemmer D, Klinge U, Kuschel S, Schuessler B (2009) Foreign body reaction in vaginally eroded and noneroded polypropylene suburethral slings in the female: a case series. Int Urogynecol J 20:1473–1476
Allahdin S, Glazener C, Bain C (2008) A randomised controlled trial evaluating the use of polyglactin mesh, polydioxanone and polyglactin sutures for pelvic organ prolapse surgery. J Obstet Gynaecol 28:427–431
Sand PK et al (2001) Prospective randomized trial of polyglactin 910 mesh to prevent recurrence of cystoceles and rectoceles. Am J Obstet Gynecol 184:1357–1362
Lind M, Larsen A, Clausen C, Osther K, Everland H (2008) Cartilage repair with chondrocytes in fibrin hydrogel and MPEG polylactide scaffold: an in vivo study in goats. Knee Surg Sports Traumatol Arthrosc 16:690–698
Chen CC, Ridgeway B, Paraiso MF (2007) Biologic grafts and synthetic meshes in pelvic reconstructive surgery. Clin Obstet Gynecol 50:383–411
Moalli PA et al (2004) Impact of menopause on collagen subtypes in the arcus tendineous fasciae pelvis. Am J Obstet Gynecol 190:620–627
Moalli PA, Debes KM, Meyn LA, Howden NS, Abramowitch SD (2008) Hormones restore biomechanical properties of the vagina and supportive tissues after surgical menopause in young rats. Am J Obstet Gynecol 199:161–168
Pessina MA, Hoyt RF Jr, Goldstein I, Traish AM (2006) Differential effects of estradiol, progesterone, and testosterone on vaginal structural integrity. Endocrinology 147:61–69
Smith P (1993) Estrogens and the urogenital tract. Studies on steroid hormone receptors and a clinical study on a new estradiol-releasing vaginal ring. Acta Obstet Gynecol Scand Suppl 157:1–26
Higgins EW et al (2009) Effect of estrogen replacement on the histologic response to polypropylene mesh implanted in the rabbit vagina model. Am J Obstet Gynecol 201:505–509
Boulanger L et al (2008) Development of an animal model to study meshes used in genital prolapse surgery. Eur J Obstet Gynecol Reprod Biol 136:254–259
Krause HG, Galloway SJ, Khoo SK, Lourie R, Goh JT (2006) Biocompatible properties of surgical mesh using an animal model. Aust N Z J Obstet Gynaecol 46:42–45
Riccetto C et al (2008) Impact of the structure of polypropylene meshes in local tissue reaction: in vivo stereological study. Int Urogynecol J Pelvic Floor Dysfunct 19:1117–1123
Huffaker RK et al (2008) Histologic response of porcine collagen-coated and uncoated polypropylene grafts in a rabbit vagina model. Am J Obstet Gynecol 198:582–587
Pierce LM et al (2009) Long-term histologic response to synthetic and biologic graft materials implanted in the vagina and abdomen of a rabbit model. Am J Obstet Gynecol 200:546–546
Rubod Cl et al (2008) Biomechanical properties of vaginal tissue: preliminary results. Int Urogynecol J 19:811–816
Ho MH et al (2009) Stimulating vaginal repair in rats through skeletal muscle-derived stem cells seeded on small intestinal submucosal scaffolds. Obstet Gynecol 114:300–309
Konstantinovic ML et al (2007) Tensile strength and host response towards different polypropylene implant materials used for augmentation of fascial repair in a rat model. Int Urogynecol J Pelvic Floor Dysfunct 18:619–626
Khouw IM et al (2000) The foreign body reaction to a biodegradable biomaterial differs between rats and mice. J Biomed Mater Res 52:439–446
Altman D, Mellgren A, Zetterstrom J (2005) Rectocele repair using biomaterial augmentation: current documentation and clinical experience. Obstet Gynecol Surv 60:753–760
Acknowledgements
We thank the animal care staff at the Panum Institute for their assistance in management of anesthesia and husbandry of the rats used in this study as well as Ms Tina Romme for technical assistance.
This study was supported by the Danish National Advanced Technology Foundation.
Conflicts of interest
L.F. Nielsen and H. Everland are employees of Coloplast.
Author information
Authors and Affiliations
Corresponding author
Additional information
An erratum to this article can be found at http://dx.doi.org/10.1007/s00192-011-1371-x
Rights and permissions
About this article
Cite this article
Boennelycke, M., Christensen, L., Nielsen, L.F. et al. Tissue response to a new type of biomaterial implanted subcutaneously in rats. Int Urogynecol J 22, 191–196 (2011). https://doi.org/10.1007/s00192-010-1257-3
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00192-010-1257-3