title: Histological inflammatory response to transvaginal polypropylene mesh for pelvic reconstructive surgery.
abstract: OBJECTIVE
  We prospectively evaluated the histological inflammatory response to the large polypropylene transvaginal mesh used for pelvic organ prolapse surgery.
  
  
  METHODS
  Ten patients and 8 controls underwent vaginal punch biopsy sampling before surgery and patients also underwent it 1 year after pelvic reconstructive surgery using polypropylene mesh. Foreign body response to the mesh was assessed using a combination of histological, semiquantitative and computerized image based analysis.
  
  
  RESULTS
  Compared to preoperative histology there was a significant postoperative increase in macrophage and mast cell counts (p = 0.03 and 0.01) but no significant changes in the count of cells involved primarily in the infectious cell response or collagen density and the elastin area fraction at the mesh-tissue interface (p = 0.2 and 0.3, respectively). Three cases of mild granuloma formation and 2 of mild erosion were observed. There was no significant change in epithelial thickness when comparing preoperative and postoperative samples.
  
  
  CONCLUSIONS
  When used for pelvic reconstructive surgery, macroporous monofilament polypropylene mesh induces a mild but persistent foreign body reaction.
authors.affiliation: Division of Surgery and Urology, Department of Clinical Sciences, Danderyd University Hospital, Stockholm, Sweden.
authors.forename: Caroline
authors.initials: C
authors.lastname: Elmer
authors.forename: Bo
authors.initials: B
authors.lastname: Blomgren
authors.forename: Christian
authors.initials: C
authors.lastname: Falconer
authors.forename: Anju
authors.initials: A
authors.lastname: Zhang
authors.forename: Daniel
authors.initials: D
authors.lastname: Altman
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005549:Foreign-Body Reaction / Q000209:etiology* / Q000473:pathology*; D006801:Humans; D008875:Middle Aged; D011126:Polypropylenes / Q000009:adverse effects*; D011446:Prospective Studies; D013526:Surgical Mesh / Q000009:adverse effects*; D014596:Uterine Prolapse / Q000601:surgery*
chemical_list: D011126:Polypropylenes