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Histologic comparison of pubovaginal sling graft materials: a comparative study.
Urology. 2008 Jul; 72(1):85-9.U

Abstract

OBJECTIVES

Little is known about the host response to the various biologic and synthetic graft materials used as substitutes for autologous fascia. We investigated the host response to sling graft materials in humans.

METHODS

A total of 24 women undergoing sling revision had a portion of the graft material removed for comparative analysis. At exploration, the degree of graft preservation (integrity), encapsulation, infection, and fibrosis was quantified. A histopathologic analysis was performed by systematically examining each specimen for the inflammatory response, neovascularity, and host fibroblast infiltration.

RESULTS

A total of 24 grafts were explanted at 2-34 months after implantation. The indications for removal were a lack of sling efficacy in 2, urinary retention in 9, and sling obstruction in 13. The types of graft material were polypropylene mesh (PPM) in 10, autologous fascia in 5, porcine dermis in 4, cadaveric dermis in 3, and cadaveric fascia in 2. No graft degradation had occurred in PPM material. Autologous and cadaveric fascia had the most demonstrable graft degradation. No encapsulation had occurred with autologous fascia or PPM. The porcine dermis was the most encapsulated. No host infiltration had occurred with the encapsulated porcine grafts, and only peripheral infiltration of fibroblasts had occurred in the cadaveric grafts. The PPM grafts had the greatest number of fibroblasts throughout the entire graft. Neovascularity was the most prevalent in mesh and was also present in the autologous fascia. Giant cells were seen in two mesh and two porcine grafts.

CONCLUSIONS

The results of our study have shown that porcine dermis has the potential to encapsulate. The degree of host tissue infiltration was greatest with PPM, and no degradation of the mesh material had occurred with time.

Authors+Show Affiliations

Department of Urology, Louisiana State University Health Sciences Center, Ochsner Clinic Foundation, New Orleans, Louisiana, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

18455763

Citation

Woodruff, Anthony J., et al. "Histologic Comparison of Pubovaginal Sling Graft Materials: a Comparative Study." Urology, vol. 72, no. 1, 2008, pp. 85-9.
Woodruff AJ, Cole EE, Dmochowski RR, et al. Histologic comparison of pubovaginal sling graft materials: a comparative study. Urology. 2008;72(1):85-9.
Woodruff, A. J., Cole, E. E., Dmochowski, R. R., Scarpero, H. M., Beckman, E. N., & Winters, J. C. (2008). Histologic comparison of pubovaginal sling graft materials: a comparative study. Urology, 72(1), 85-9. https://doi.org/10.1016/j.urology.2008.03.012
Woodruff AJ, et al. Histologic Comparison of Pubovaginal Sling Graft Materials: a Comparative Study. Urology. 2008;72(1):85-9. PubMed PMID: 18455763.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Histologic comparison of pubovaginal sling graft materials: a comparative study. AU - Woodruff,Anthony J, AU - Cole,Emily E, AU - Dmochowski,Roger R, AU - Scarpero,Harriette M, AU - Beckman,Edwin N, AU - Winters,J Christian, Y1 - 2008/05/05/ PY - 2006/04/02/received PY - 2008/02/22/revised PY - 2008/03/05/accepted PY - 2008/5/6/pubmed PY - 2008/8/6/medline PY - 2008/5/6/entrez SP - 85 EP - 9 JF - Urology JO - Urology VL - 72 IS - 1 N2 - OBJECTIVES: Little is known about the host response to the various biologic and synthetic graft materials used as substitutes for autologous fascia. We investigated the host response to sling graft materials in humans. METHODS: A total of 24 women undergoing sling revision had a portion of the graft material removed for comparative analysis. At exploration, the degree of graft preservation (integrity), encapsulation, infection, and fibrosis was quantified. A histopathologic analysis was performed by systematically examining each specimen for the inflammatory response, neovascularity, and host fibroblast infiltration. RESULTS: A total of 24 grafts were explanted at 2-34 months after implantation. The indications for removal were a lack of sling efficacy in 2, urinary retention in 9, and sling obstruction in 13. The types of graft material were polypropylene mesh (PPM) in 10, autologous fascia in 5, porcine dermis in 4, cadaveric dermis in 3, and cadaveric fascia in 2. No graft degradation had occurred in PPM material. Autologous and cadaveric fascia had the most demonstrable graft degradation. No encapsulation had occurred with autologous fascia or PPM. The porcine dermis was the most encapsulated. No host infiltration had occurred with the encapsulated porcine grafts, and only peripheral infiltration of fibroblasts had occurred in the cadaveric grafts. The PPM grafts had the greatest number of fibroblasts throughout the entire graft. Neovascularity was the most prevalent in mesh and was also present in the autologous fascia. Giant cells were seen in two mesh and two porcine grafts. CONCLUSIONS: The results of our study have shown that porcine dermis has the potential to encapsulate. The degree of host tissue infiltration was greatest with PPM, and no degradation of the mesh material had occurred with time. SN - 1527-9995 UR - https://www.unboundmedicine.com/medline/citation/18455763/Histologic_comparison_of_pubovaginal_sling_graft_materials:_a_comparative_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0090-4295(08)00343-9 DB - PRIME DP - Unbound Medicine ER -