Can platelet-rich plasma coating improve polypropylene mesh integration? An immunohistochemical analysis in rabbits

Int Braz J Urol. 2021 Mar-Apr;47(2):287-294. doi: 10.1590/S1677-5538.IBJU.2020.0017.

Abstract

Purpose: Despite high success rates in the treatment of urinary incontinence, complications related to the use of polypropylene (PP) meshes are still a concern, especially in vaginal prolapses surgeries. The objective of this study was to assess the effect of autologous platelet-rich plasma (PRP) coating on the integration of PP meshes implanted in the vaginal submucosa of rabbits.

Materials and methods: Thirty adult New Zealand rabbits were randomly divided into two groups (n=15): PP, implanted with conventional PP meshes; and PRP, implanted with autologous PRP coated PP meshes. Animals in both groups (n=5) were euthanized at 7, 30 and 90 days postoperatively, the vaginas extracted and sent to immunohistochemical analysis for the assessment of the pro-inflammatory agent TNF-α, anti-inflammatory agents TGF-β and IL-13, collagen metabolism marker MMP-2, and angiogenesis marker CD-31. AxioVision™ image analysis was used for the calculation of the immunoreactive area and density. Statistical analysis was performed with ANOVA followed by Tukey test (p <0.05).

Results: Animals in the PRP group showed significantly increased expression of the angiogenesis agent CD-31 at all experimental times when compared to the PP group (p <0.0001). However, no differences concerning the expression of the other markers were observed between the groups.

Conclusion: The addition of autologous PRP gel to PP meshes can be simply and safely achieved and seems to have a positive effect on implantation site angiogenesis. Further investigations are required to ascertain PPR coated meshes clinical efficacy in prolapses and stress urinary incontinence surgeries.

Keywords: Suburethral Slings; Tissue Engineering; Urinary Incontinence; Female.

MeSH terms

  • Animals
  • Collagen
  • Female
  • Platelet-Rich Plasma*
  • Polypropylenes*
  • Rabbits
  • Surgical Mesh
  • Vagina / surgery

Substances

  • Polypropylenes
  • Collagen