Symptomatic stress urinary incontinence (SUI) and pelvic organ prolapse (POP) refractory to conservative management with pelvic floor muscle training or vaginal pessaries, may warrant surgical intervention with different forms of biologic or synthetic material.
However, in recent years several global regulatory agencies have issued health warnings and recalled several mesh products due to an increase in complications such as mesh erosion, infection, chronic pain and perioperative bleeding. At present current surgical treatment strategies for SUI and POP are aimed at developing biological graft materials with similar mechanical properties to established synthetic meshes but with improved tissue integration and minimal host-response. This narrative review aims to highlight recent studies related to the development of biomimetic and biologic graft materials as alternatives to traditional synthetic materials for SUI/POP repair in female patients. We also investigate complications and technical limitations associated with synthetic mesh and biological biomaterials in conventional SUI and POP surgery. Our findings demonstrate that newly developed biologic grafts have a lower incidence of adverse events compared to synthetic biomaterials. However there remains a significant disparity between success in preclinical trials and long-term clinical translation. Further characterisation on the optimal structural, integrative and mechanical properties of biological grafts are required before they can be reliably introduced into clinical practice for SUI and POP surgery.
Tissue engineering. Part B, Reviews. 2020 Mar 20 [Epub ahead of print]
Jack Whooley, Eoghan M Cunnane, Ronaldo Do Amaral, Michael Joyce, Eoin MacCraith, Hugh D Flood, Fergal J O'Brien, Niall F Davis
Beaumont Hospital, 57978, Department of Urology and Transplantation Surgery, Beaumont Road, Beaumont, Dublin 9, Dublin, Leinster, Ireland, D09 YD60; ., Tissue Engineering Research Group, Department of Anatomy and Regenerative Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland; Trinity Centre for Biomedical Engineering, Trinity College Dublin, Dublin, Ireland; Advanced Materials and Bioengineering Research Centre (AMBER), RCSI and TCD, Dublin, Ireland, Dublin , Ireland; ., Tissue Engineering Research Group, Department of Anatomy and Regenerative Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland; Trinity Centre for Biomedical Engineering, Trinity College Dublin, Dublin, Ireland; Advanced Materials and Bioengineering Research Centre (AMBER), RCSI and TCD, Dublin, Ireland, Dublin, Ireland; ., Tissue Engineering Research Group, Department of Anatomy and Regenerative Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland; Trinity Centre for Biomedical Engineering, Trinity College Dublin, Dublin, Ireland; Advanced Materials and Bioengineering Research Centre (AMBER), RCSI and TCD, Dublin, Ireland, Dublin , Ireland; ., Beaumont Hospital, 57978, Department of Urology and Transplantation Surgery, Dublin, Leinster, Ireland; ., Tissue Engineering Research Group, Department of Anatomy and Regenerative Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland; Trinity Centre for Biomedical Engineering, Trinity College Dublin, Dublin, Ireland; Advanced Materials and Bioengineering Research Centre (AMBER), RCSI and TCD, Dublin, Ireland, Dublin, Ireland; ., Tissue Engineering Research Group, Department of Anatomy and Regenerative Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland; Trinity Centre for Biomedical Engineering, Trinity College Dublin, Dublin, Ireland; Advanced Materials and Bioengineering Research Centre (AMBER), RCSI and TCD, Dublin, Ireland, Dublin , Ireland; ., Beaumont Hospital, 57978, Department of Urology and Transplantation Surgery, Dublin, Leinster, Ireland.
PubMed http://www.ncbi.nlm.nih.gov/pubmed/32192400