Introducing a method of in vitro testing of different anchoring systems used for female incontinence and prolapse surgery.
OBJECTIVE
To develop a method for in vitro testing to compare different intracorporeal anchoring systems (AS) used, for example, in single-incision slings or vaginal meshes. Intracorporeal fixation needs reliable anchorage systems, which keep the implant in the operative and early postoperative phase in place. Up to now, the impact of the design of current anchor systems and their capability to provide sufficient retention forces is not known.


METHODS
Four AS ("PelFix", "Surelift", "TFS", and "MiniArc") were evaluated in an animal model and a ballistic gelatine model with pull-out tests. We performed ANOVA with post hoc Bonferroni. Results were presented as mean values whereby a significance level of <0.05 was considered significant.


RESULTS
The four systems showed significantly different pull-out forces. Depending on mesh structure, size, and form of the AS, mechanical strain resulted in deformation with local peak stresses. Under the condition of form stability, relative differences of pull-out forces did not change in different tissues.


CONCLUSIONS
Reliable testing of different AS in their ability to keep mesh implants in place can be done in animal models and in especially designed ballistic gelatine. These methods of testing will help to modify AS in novel pelvic floor implants.
Department of Neuro-Urology, University Hospital, Rheinische Friedrich-Wilhelms-University, 53127 Bonn, Germany.
Ralf
R
Anding
Department of Neuro-Urology, University Hospital, Rheinische Friedrich-Wilhelms-University, 53127 Bonn, Germany.
Ruth
R
Tabaza
Institute of Bioengineering, FH Aachen University of Applied Sciences, Juelich Campus, 52428 Juelich, Germany.
Manfred
M
Staat
Institute of Bioengineering, FH Aachen University of Applied Sciences, Juelich Campus, 52428 Juelich, Germany.
Eva
E
Trenz
Institute of Bioengineering, FH Aachen University of Applied Sciences, Juelich Campus, 52428 Juelich, Germany.
Philipp
P
Lohmann
Department of Surgery, University Hospital RWTH Aachen, 52074 Aachen, Germany.
Uwe
U
Klinge
Department of Neuro-Urology, University Hospital, Rheinische Friedrich-Wilhelms-University, 53127 Bonn, Germany.
Ruth
R
Kirschner-Hermanns
D000818:Animals; D004195:Disease Models, Animal; D005260:Female; D005780:Gelatin / Q000737:chemistry / Q000627:therapeutic use; D006801:Humans; D017773:Pelvic Floor / Q000473:pathology / Q000601:surgery*; D011391:Prolapse; D019736:Prostheses and Implants; D013552:Swine
D005780:Gelatin