title: Biomaterials for pelvic floor reconstructive surgery: how can we do better?
abstract: Stress urinary incontinence (SUI) and pelvic organ prolapse (POP) are major health issues that detrimentally impact the quality of life of millions of women worldwide. Surgical repair is an effective and durable treatment for both conditions. Over the past two decades there has been a trend to enforce or reinforce repairs with synthetic and biological materials. The determinants of surgical outcome are many, encompassing the physical and mechanical properties of the material used, and individual immune responses, as well surgical and constitutional factors. Of the current biomaterials in use none represents an ideal. Biomaterials that induce limited inflammatory response followed by constructive remodelling appear to have more long term success than biomaterials that induce chronic inflammation, fibrosis and encapsulation. In this review we draw upon published animal and human studies to characterize the changes biomaterials undergo after implantation and the typical host responses, placing these in the context of clinical outcomes.
authors.affiliation: Material Science Engineering, University of Sheffield, Sheffield S1 3JD, UK.
authors.forename: Giulia
authors.identifier: 0000-0003-3355-1100
authors.initials: G
authors.lastname: Gigliobianco
authors.affiliation: Material Science Engineering, University of Sheffield, Sheffield S1 3JD, UK.
authors.forename: Sabiniano Roman
authors.identifier: 0000-0002-2368-7955
authors.initials: SR
authors.lastname: Regueros
authors.affiliation: Material Science Engineering, University of Sheffield, Sheffield S1 3JD, UK ; Royal Hallamshire Hospital, Sheffield S10 2JF, UK.
authors.forename: Nadir I
authors.initials: NI
authors.lastname: Osman
authors.affiliation: Hospital das Clínicas da Faculdade de Medicina, Universidade de Sao Paulo, 05410-020 São Paulo, Brazil.
authors.forename: Julio
authors.initials: J
authors.lastname: Bissoli
authors.affiliation: Material Science Engineering, University of Sheffield, Sheffield S1 3JD, UK.
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Bullock
authors.affiliation: Royal Hallamshire Hospital, Sheffield S10 2JF, UK.
authors.forename: Chris R
authors.initials: CR
authors.lastname: Chapple
authors.affiliation: Material Science Engineering, University of Sheffield, Sheffield S1 3JD, UK.
authors.forename: Sheila
authors.identifier: 0000-0002-9188-5769
authors.initials: S
authors.lastname: MacNeil
mesh_terms: D001672:Biocompatible Materials / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D017773:Pelvic Floor / Q000503:physiopathology / Q000601:surgery; D056887:Pelvic Organ Prolapse / Q000473:pathology / Q000601:surgery*; D019651:Plastic Surgery Procedures; D013526:Surgical Mesh; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000473:pathology / Q000601:surgery*
chemical_list: D001672:Biocompatible Materials