Polypropylene pelvic mesh: what went wrong and what will be of the future?
File(s)
Author(s)
Seifalian, Amelia
Basma, Zeinab
Digesu, Alex
Khullar, Vikram
Type
Journal Article
Abstract
Background: Polypropylene (PP) pelvic mesh is a synthetic mesh made of PP polymer used to treat pelvic organ prolapse (POP). Its use has become highly controversial due to reports of serious complications. This research critically reviews the current management options for POP and PP mesh as a viable clinical application for the treatment of POP. The safety and suitability of PP material were rigorously studied and critically evaluated, with consideration to the mechanical and chemical properties of PP. We proposed the ideal properties of the ‘perfect’ synthetic pelvic mesh with emerging advanced materials. Methods: We performed a literature review using PubMed/Medline, Embase, Cochrane Library (Wiley) databases, and ClinicalTrials.gov databases, including the relevant keywords: pelvic organ prolapse (POP), polypropylene mesh, synthetic mesh, and mesh complications. Results: The results of this review found that although PP is nontoxic, its physical properties demonstrate a significant mismatch between its viscoelastic properties compared to the surrounding tissue, which is a likely cause of complications. In addition, a lack of integration of PP mesh into surrounding tissue over longer periods of follow up is another risk factor for irreversible complications. Conclusions: PP mesh has caused a rise in reports of complications involving chronic pain and mesh exposure. This is due to the mechanical and physicochemical properties of PP mesh. As a result, PP mesh for the treatment of POP has been banned in multiple countries, currently with no alternative available. We propose the development of a pelvic mesh using advanced materials including emerging graphene-based nanocomposite materials.
Date Issued
2023-03
Date Acceptance
2023-02-23
Citation
Biomedicines, 2023, 11 (3)
ISSN
2227-9059
Publisher
MDPI AG
Journal / Book Title
Biomedicines
Volume
11
Issue
3
Copyright Statement
© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
License URL
Identifier
https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000954891100001&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=a2bf6146997ec60c407a63945d4e92bb
Subjects
Biochemistry & Molecular Biology
BIOMECHANICAL PROPERTIES
COMPLICATIONS
graphene
Hastalex
IMPLANTATION
Life Sciences & Biomedicine
material
Medicine, Research & Experimental
ORGAN PROLAPSE
pelvic mesh
pelvic organ prolapse
Pharmacology & Pharmacy
polypropylene
regenerative medicine
REPAIR
Research & Experimental Medicine
SACROCOLPOPEXY
Science & Technology
smart materials
STRESS URINARY-INCONTINENCE
SYNTHETIC MESH
tissue engineering
TRANSVAGINAL MESH
urogynaecology
VAGINAL WALL PROLAPSE
Publication Status
Published
Article Number
741
Date Publish Online
2023-03-01