title: The impact of prolapse mesh on vaginal smooth muscle structure and function.
abstract: OBJECTIVE
  To evaluate the impact of prolapse meshes on vaginal smooth muscle structure (VaSM) and function, and to evaluate these outcomes in the context of the mechanical and textile properties of the mesh.
  
  
  METHODS
  Three months following the implantation of three polypropylene prolapse meshes with distinct textile and mechanical properties, mesh tissue explants were evaluated for smooth muscle contraction, innervation, receptor function, and innervation density.
  
  
  METHODS
  Magee-Womens Research Institute at the University of Pittsburgh.
  
  
  METHODS
  Thirty-four parous rhesus macaques of similar age, parity, and pelvic organ prolapse quantification (POP-Q) scores.
  
  
  METHODS
  Macaques were implanted with mesh via sacrocolpopexy. The impact of Gynemesh(™)  PS (Ethicon; n = 7), Restorelle(®) (Coloplast; n = 7), UltraPro(™) parallel and UltraPro(™) perpendicular (Ethicon; n = 6 and 7, respectively) were compared with sham-operated controls (n = 7). Outcomes were analysed by Kruskal-Wallis ANOVA, Mann-Whitney U-tests and multiple regression analysis (P < 0.05).
  
  
  METHODS
  Vaginal tissue explants were evaluated for the maximum contractile force generated following muscle, nerve, and receptor stimulation, and for peripheral nerve density.
  
  
  RESULTS
  Muscle myofibre, nerve, and receptor-mediated contractions were negatively affected by mesh only in the grafted region (P < 0.001, P = 0.002, and P = 0.008, respectively), whereas cholinergic and adrenergic nerve densities were affected in the grafted (P = 0.090 and P = 0.008, respectively) and non-grafted (P = 0.009 and P = 0.005, respectively) regions. The impact varied by mesh property, as mesh stiffness was a significant predictor of the negative affect on muscle function and nerve density (P < 0.001 and P = 0.013, respectively), whereas mesh and weight was a predictor of receptor function (P < 0.001).
  
  
  CONCLUSIONS
  Mesh has an overall negative impact on VaSM, and the effects are a function of mesh properties, most notably, mesh stiffness.
  
  
  CONCLUSIONS
  Prolapse mesh affects vaginal smooth muscle.
authors: Musculoskeletal Research Center, Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA.
authors: Z
authors: Z
authors: Jallah
authors: Magee-Womens Research Institute, Department of Obstetrics, Gynecology and Reproductive Science, University of Pittsburgh, Pittsburgh, PA, USA.
authors: R
authors: R
authors: Liang
authors: Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, Georgia, USA.
authors: A
authors: A
authors: Feola
authors: Musculoskeletal Research Center, Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA.
authors: W
authors: W
authors: Barone
authors: Magee-Womens Research Institute, Department of Obstetrics, Gynecology and Reproductive Science, University of Pittsburgh, Pittsburgh, PA, USA.
authors: S
authors: S
authors: Palcsey
authors: Musculoskeletal Research Center, Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA.|Magee-Womens Research Institute, Department of Obstetrics, Gynecology and Reproductive Science, University of Pittsburgh, Pittsburgh, PA, USA.
authors: S D
authors: SD
authors: Abramowitch
authors: Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
authors: N
authors: N
authors: Yoshimura
authors: Musculoskeletal Research Center, Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA.|Magee-Womens Research Institute, Department of Obstetrics, Gynecology and Reproductive Science, University of Pittsburgh, Pittsburgh, PA, USA.
authors: P
authors: P
authors: Moalli
mesh_terms: D059331:Adrenergic Neurons / Q000473:pathology / Q000502:physiology; D000818:Animals; D001696:Biomechanical Phenomena; D001706:Biopsy / Q000379:methods; D059329:Cholinergic Neurons / Q000473:pathology / Q000502:physiology; D004867:Equipment Design; D005260:Female; D008253:Macaca mulatta; D018721:Muscarinic Agonists / Q000494:pharmacology; D009119:Muscle Contraction / Q000502:physiology; D018485:Muscle Fibers, Skeletal / Q000473:pathology / Q000502:physiology; D009130:Muscle, Smooth / Q000294:innervation / Q000473:pathology* / Q000503:physiopathology; D056887:Pelvic Organ Prolapse / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D010525:Peripheral Nerves / Q000473:pathology / Q000503:physiopathology; D011126:Polypropylenes / Q000008:administration & dosage / Q000009:adverse effects*; D011976:Receptors, Muscarinic / Q000187:drug effects / Q000502:physiology; D013526:Surgical Mesh / Q000009:adverse effects*; D014621:Vagina / Q000294:innervation / Q000473:pathology* / Q000503:physiopathology
chemical_list: D018721:Muscarinic Agonists; D011126:Polypropylenes; D011976:Receptors, Muscarinic
keywords: Peripheral nerves; polypropylene mesh; smooth muscle