[Tissue reaction to polypropylene mono-or multi-filament tapes used in surgical techniques of stress urinary incontinence treatment].
OBJECTIVE
The "gold standard" in surgical treatment of stress urinary incontinence (SUI) is sling operation with polypropylene tape appliance under the mid urethra. There are two types of polypropylene tape which are the most popular nowadays. These two tapes are differently knitted so they have different biomechanical features. The TVT tape is monofilament, rarely knitted and highly elastic but the IVS mesh is multifilament, densly knitted and has only little possibility to stretch. The aim of our study was to assess the tissue reaction to the mono-(TVT) and multifilament (IVS) tapes.


METHODS
The 10 mm x 10 mm pieces of TVT and IVS tapes were implanted inlay the fascia of musculus abdominis rectus of 14 rat females (2 groups of 7 animals). The tapes with the margin of surrounding fascia were taken off after 6 weeks of healing. All samples were fixed in 10% Formaldehyde in phosphate buffered saline and embedded in paraffin. Four micron tissue sections were stained with hematoxylin and eosin, the reticulin silver impregnation stain according to Gomori (for collagen type III) and periodic acid Schiff and alcian blue (for proteoglycan).


RESULTS
In all sections filaments visible as elipsoids were surrounded by resorptive granulation with large multinucleated giant cells like around "foreign body". The diameter of monofilaments was about 150 microns. The connective tissue in the vicinity of mesh was rich of inflammatory cells like histiocytes, lymphocytes, a few polymorphonuclear leucocytes as well as adipocytes and fibroblasts. The large multinucleated giant cells adjacent to monofilaments were relatively bigger than these cells around multifilaments. Moreover, this granulation tissue has a lot of new blood vessels and collagenous fibrous tissue. The multifilaments were about 40 microns in diameter. The inflammatory granulation infiltrated aggregates of multifilaments. This tissue had only few inflammatory cells in comparison to tissue around monofilaments. The large multinucleated giant cells apposed to the mesh were small and collagen created thicker, more compacted bundles.


CONCLUSIONS
The multifilament polypropylene tape induces weaker inflammatory tissue reaction than monofilament mesh. The thicker and more compacted collagen bundles are created around multifilaments so the natural tensile strength of the surrounding tissue is probably higher.
Rechberger
Tomasz
T
II Katedry i Kliniki Ginekologii AM w Lublinie.
Wróbel
Andrzej
A
Adamiak
Aneta
A
Skomra
Danuta
D
Korobowicz
Elzbieta
E
Tomaszewski
Jacek
J
Czuczwar
Mirosław
M
Skorupski
Paweł
P
D000818:Animals; D001672:Biocompatible Materials / Q000592:standards; D005260:Female; D020007:Implants, Experimental / Q000592:standards*; D011126:Polypropylenes / Q000592:standards*; D051381:Rats; D013526:Surgical Mesh / Q000592:standards*; D013997:Time Factors; D016896:Treatment Outcome; D014463:Ultrasonography; D014550:Urinary Incontinence, Stress / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*
D001672:Biocompatible Materials; D011126:Polypropylenes