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

• Published in: International Urogynecology Journal 2022-07, Vol.33 (7), p.1839-1848
• Main Authors: Lo, Tsia-Shu, Lin, Yi-Hao, Huang, Ting-Xuan, Chu, Hsiao-Chien, Chen, Yi-Pin
• Format: Article
• Language: English
• Subjects: Bladder; Catheters; Gynecology; Hospitals; Medicine; Medicine & Public Health; Obstetrics; Original Article; Rodents; Surgery; Urology; Vagina
• ISSN: 0937-3462; 1433-3023
• DOI: 10.1007/s00192-021-04842-7

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.