Effect of suburethral prolene mesh for suburethral function and histology in a stress urinary incontinence mouse model.
OBJECTIVE
To create a mouse model pertaining to mesh-elicited suburethral functional and histological changes after vaginal distention, and to examine the possible mechanism behind these complications.


METHODS
We divided 48 virgin female C57BL/6 mice into four groups: vaginal distention alone, vaginal distention followed by prolene mesh implantation, vaginal distention followed by sham mesh implantation and untreated control. Each group was divided into two subgroups for conscious cystometrogram, leak-point pressure testing and harvesting of suburethral tissue 4 or 10 days after vaginal distention. The suburethral tissues underwent immunohistochemistry and western blot analysis of nerve growth factor, matrix metalloproteinase 2 and tissue inhibitor of metalloproteinase 2. Urodynamic results were compared among groups using one way ANOVA, with Tukey's multiple comparisons post-test for pair wise comparisons.


RESULTS
Leak-point pressure in the vaginal distention and vaginal distention + sham mesh groups were significantly lower than in the control and vaginal distention + mesh groups at day 4. Leak-point pressure in the vaginal distention + mesh group were significantly higher than in the other three groups at both day 4 and 10. Immunohistochemistry and western blotting showed increased matrix metalloproteinase 2 and tissue inhibitor of metalloproteinase 2 levels in the vaginal distention + mesh group at day 4 and 10. Furthermore, nerve growth factor expression was increased in the same area and same group at 10 days.


CONCLUSIONS
Increased suburethral tissue matrix metalloproteinase and nerve growth factor expression might be related to tissue remodeling after prolene mesh implantation for stress urinary incontinence.
Division of Urogynecology, Department of Obstetrics and Gynecology, Linkou Medical Center, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan.
Yi-Hao
YH
Lin
Division of Urogynecology, Department of Obstetrics and Gynecology, Linkou Medical Center, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan.
Alex C
AC
Wang
Division of Urogynecology, Department of Obstetrics and Gynecology, Linkou Medical Center, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan.
Pei-Ying
PY
Wu
Division of Urogynecology, Department of Obstetrics and Gynecology, Linkou Medical Center, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan.
Hsiao-Chien
HC
Chu
Division of Urogynecology, Department of Obstetrics and Gynecology, Linkou Medical Center, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan.
Ching-Chung
CC
Liang
Department of Urology, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio, USA.
Firouz
F
Daneshgari
D000818:Animals; D004195:Disease Models, Animal; D005260:Female; D007150:Immunohistochemistry; D020778:Matrix Metalloproteinase 2 / Q000378:metabolism; D051379:Mice; D008810:Mice, Inbred C57BL; D020932:Nerve Growth Factor / Q000378:metabolism; D019736:Prostheses and Implants; D013526:Surgical Mesh; D019716:Tissue Inhibitor of Metalloproteinase-2 / Q000378:metabolism; D014521:Urethra / Q000473:pathology*; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D013520:Urologic Surgical Procedures; D014621:Vagina / Q000601:surgery*
D019716:Tissue Inhibitor of Metalloproteinase-2; D020932:Nerve Growth Factor; D020778:Matrix Metalloproteinase 2; C522362:Mmp2 protein, mouse
leak-point pressure; matrix metalloproteinase; nerve growth factor; tissue inhibitors of metalloproteinase; vaginal mesh complication