The in vivo biocompatibility of titanized polypropylene lightweight mesh is superior to that of conventional polypropylene mesh

Neurourol Urodyn. 2020 Jan;39(1):96-107. doi: 10.1002/nau.24159. Epub 2019 Oct 4.

Abstract

Objective: To evaluate the histological response to and changes in the biomechanical properties of titanized polypropylene lightweight mesh and conventional polypropylene mesh at 1 and 12 weeks following implantation in the sheep vagina.

Methods: We compared a titanized polypropylene lightweight mesh (TiLOOP Mesh) to a conventional polypropylene mesh (Gynemesh PS) in a sheep vagina model. Explants were harvested after 1 and 12 weeks (n = 6/mesh type/time point) for histological observation. After 12 weeks, mesh-tissue complex specimens were biomechanically assessed by a uniaxial tension system.

Results: One week after implantation, there was no significant difference in the inflammatory response between the two groups. Twelve weeks after implantation, the TiLOOP light mesh elicited a lower inflammatory response than was observed for the Gynemesh PS (1.44 ± 0.61 vs 2.05 ± 0.80, P = .015). Twelve weeks after implantation, the collagen I/III ratio was lower in the TiLOOP light mesh group than in the Gynemesh PS group (9.41 ± 5.06 vs 15.21 ± 8.21, P = .019). The messenger RNA expression levels of the inflammatory factors interleukin 10 and tumor necrosis factor α were lower in the TiLOOP Mesh group than in the Gynemesh PS group at both 1 and 12 weeks (P < .05). There were no significant differences in any of the evaluated biomechanical characteristics between the two meshes (P > .05).

Conclusion: Although the titanized polypropylene lightweight mesh induces slightly less tissue reactivity and has better in vivo biocompatibility, further studies should be conducted including the complications and the success rate of pelvic organ prolapse in patients before recommending it in pelvic floor reconstruction.

Keywords: biomechanics; inflammatory response; lightweight titanium polypropylene mesh; polypropylene mesh; sheep model.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Biocompatible Materials*
  • Biomechanical Phenomena
  • Collagen / metabolism
  • Female
  • Inflammation / etiology
  • Interleukin-10 / biosynthesis
  • Materials Testing*
  • Pelvic Floor / surgery
  • Polypropylenes*
  • Sheep, Domestic
  • Surgical Mesh*
  • Titanium*
  • Tumor Necrosis Factor-alpha / biosynthesis
  • Vagina

Substances

  • Biocompatible Materials
  • Polypropylenes
  • Tumor Necrosis Factor-alpha
  • Interleukin-10
  • Collagen
  • Titanium