Biodegradable materials for surgical management of stress urinary incontinence: a narrative review
journal contributionposted on 2022-07-12, 13:21 authored by Eoin MaccraithEoin Maccraith, Fergal O'BrienFergal O'Brien, NF Davis
Stress urinary incontinence (SUI) was managed with techniques such as colposuspension, autologous fascia sling and urethral bulking agents. The introduction of the mid-urethral polypropylene (PP) sling in the 1990s led to a significant and rapid global change in SUI surgery. The synthetic non-degradable PP sling had superior results to traditional SUI procedures but its use has now declined due to significant complications such as pain and mesh erosion. These complications are attributed to its poor biocompatibility and integration into vaginal tissues. The efficacy of PP was extrapolated from studies on abdominal wall repair and it is now clear that integration of implanted materials in the pelvic floor differs from the abdominal wall. With PP prohibited in some jurisdictions, female patients with SUI have few management options. In the present review we summarise recent advances in SUI surgery and evaluate potential alternatives to PP slings with a particular focus on degradable materials. Allograft and xenograft materials demonstrate good biocompatibility but have yielded suboptimal cure rates. Tissue engineered synthetic degradable materials outperform unmodified synthetic degradable materials in terms of biomechanics and cell support. Synthetic tissue engineered degradable materials show promising results from in vitro studies and future research should focus on animal and human trials in this field.
RCSI – Blackrock Clinic StAR MD programme 2020.
CommentsThe original article is available at https://www.sciencedirect.com/
Published CitationMacCraith E, O'Brien FJ, Davis NF. Biodegradable materials for surgical management of stress urinary incontinence: a narrative review. Eur J Obstet Gynecol Reprod Biol. 2021;259:153-160.
Publication Date26 February 2021
- Anatomy and Regenerative Medicine
- Tissue Engineering Research Group (TERG)
- Immunity, Infection and Inflammation
- Chemistry and Pharmaceutical Sciences
- Biomaterials and Regenerative Medicine
- Accepted Version (Postprint)
UrethraHumansUrinary Incontinence, StressPolypropylenesUrologic Surgical ProceduresSurgical MeshFemaleMaleSuburethral SlingsDegradableMeshPolypropyleneSlingStress urinary incontinenceTissue engineeringObstetrics & Reproductive MedicinePaediatrics and Reproductive MedicineBiomaterialsNephrology and Urology