Novel biomaterials for pelvic organ prolapse (POP) repair.

POP is the descent of one or more of the pelvic structures into the vagina and includes uterine, vaginal vault as well as anterior and posterior vaginal wall prolapse. Treatment of POP includes surgical treatment and/or implantation of synthetic mesh. However, the long-term outcome of synthetic mesh surgery is unsatisfactory due to surgical failure and post-surgical complications. We have fabricated 3 novel warpknitted synthetic scaffolds, Polyetheretherketone (PEEK), Polyamide (PA) and gelatine coated PA (PA+G). Our aim was to compare the in vivo biocompatibility of these meshes with a commercial Polypropylene (PP) mesh. A SD rat abdominal hernia model was used to implant PA, PEEK, PA+G, PP meshes (25 . 35 mm, n = 24/gp). After 7, 30, 60, 90 days tissues (n = 6/mesh) were explanted for immunohistochemical assessment of foreign body reaction and tissue integration, using CD31, CD45, CD68, alpha-SMA antibodies. CD68+ macrophages showed a trend toward decreased numbers in PP compared to PA, PA+G and PEEK. The smooth muscle content at 60 days was significantly higher in PA and PA+G meshes compared to PP (p > 0.05), but there were no significant differences at 90 days. The collagen content was similar for all meshes at 90 days(p > 0.05). PA, PA+G and PEEK appear to have similar biocompatibility properties compared to PP, inducing a similar foreign body reaction response. These novel meshes may provide an alternative option for future treatment of POP.