title: Characterizing the ex vivo textile and structural properties of synthetic prolapse mesh products.
abstract: OBJECTIVE
  The use of polypropylene meshes for surgical repair of pelvic organ prolapse (POP) has been limited by complications, including mesh exposure, encapsulation, and pain. Numerous products are available with a wide array of textile and structural properties. It is thought that complications may be related, in part, to mesh structural properties. However, few descriptions of these properties exists to directly compare products. The aim of this study was to determine the textile and structural properties of five commonly used prolapse mesh products using a ball-burst failure protocol.
  
  
  METHODS
  Porosity, anisotropic index, and stiffness of Gynemesh PS (n = 8), the prototype polypropylene mesh for prolapse repair, was compared with four newer-generation mesh produces: UltraPro (n = 5), SmartMesh (n = 5), Novasilk (n = 5), and Polyform (n = 5).
  
  
  RESULTS
  SmartMesh was found to be the most porous, at 78 % ± 1.4 %. This value decreased by 21 % for Gynemesh PS (p < 0.001), 14 % for UltraPro and Novasilk (p < 0.001), and 28 % for Polyform (p < 0.001). Based on the knit pattern, SmartMesh and Polyform were the only products considered to be geometrically isotropic, whereas all other meshes were anisotropic. Comparing the structural properties of these meshes, Gynemesh PS and Polyform were the stiffest: 60 % and 42 % stiffer than SmartMesh (p < 0.001) and Novasilk (p < 0.001), respectively. However, no significant differences were found between these two mesh products and UltraPro.
  
  
  CONCLUSIONS
  Porosity, anisotropy, and biomechanical behavior of these five commonly used polypropylene mesh products were significantly different. This study provides baseline data for future implantation studies of prolapse mesh products.
authors.affiliation: Musculoskeletal Research Center, Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Andrew
authors.initials: A
authors.lastname: Feola
authors.forename: William
authors.initials: W
authors.lastname: Barone
authors.forename: Pamela
authors.initials: P
authors.lastname: Moalli
authors.forename: Steven
authors.initials: S
authors.lastname: Abramowitch
mesh_terms: D001696:Biomechanical Phenomena; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000295:instrumentation; D006801:Humans; D008422:Materials Testing; D056887:Pelvic Organ Prolapse / Q000601:surgery; D016062:Porosity; D013526:Surgical Mesh