title: Application of Tissue Engineering to Pelvic Organ Prolapse and Stress Urinary Incontinence.
abstract: Synthetic or biological materials can be used for the surgical repair of pelvic organ prolapse (POP) or stress urinary incontinence (SUI). While non-degradable synthetic mesh has a low failure rate, it is prone to complications such as infection and erosion, particularly in the urological/gynecological setting when subject to chronic influences of gravity and intermittent, repetitive strain. Biological materials have lower complication rates, although allografts and xenografts have a high risk of failure and the theoretical risk of infection. Autografts are used successfully for the treatment of SUI and are not associated with erosion; however, can lead to morbidity at the donor site. Tissue engineering has thus become the focus of interest in recent years as researchers seek an ideal tissue remodeling material for urogynecological repair. Herein, we review the directions of current and future research in this exciting field. Electrospun poly-L-lactic acid (PLA) and porcine small intestine submucosa (SIS) are two promising scaffold material candidates. Adipose-derived stem cells (ADSCs) appear to be a suitable cell type for scaffold seeding, and cells grown on scaffolds when subjected to repetitive biaxial strain show more appropriate biomechanical properties for clinical implantation. After implantation, an appropriate level of acute inflammation is important to precipitate moderate fibrosis and encourage tissue strength. New research directions include the use of bioactive materials containing compounds that may help facilitate integration of the new tissue. More research with longer follow-up is needed to ascertain the most successful and safe methods and materials for pelvic organ repair and SUI treatment.
authors.affiliation: Sheffield Teaching Hospitals, Royal Hallamshire Hospital, Sheffield, UK.
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Chapple
authors.affiliation: Sheffield Teaching Hospitals, Royal Hallamshire Hospital, Sheffield, UK.|Department of Materials and Science Engineering, Kroto Research Institute, University of Sheffield, Sheffield, UK.
authors.forename: Nadir I
authors.initials: NI
authors.lastname: Osman
authors.affiliation: Sheffield Teaching Hospitals, Royal Hallamshire Hospital, Sheffield, UK.|Department of Materials and Science Engineering, Kroto Research Institute, University of Sheffield, Sheffield, UK.
authors.forename: Altaf
authors.initials: A
authors.lastname: Mangera
authors.affiliation: Sheffield Teaching Hospitals, Royal Hallamshire Hospital, Sheffield, UK.|Department of Materials and Science Engineering, Kroto Research Institute, University of Sheffield, Sheffield, UK.
authors.forename: Christopher
authors.initials: C
authors.lastname: Hillary
authors.affiliation: Department of Materials and Science Engineering, Kroto Research Institute, University of Sheffield, Sheffield, UK.
authors.forename: Sabiniano
authors.initials: S
authors.lastname: Roman
authors.affiliation: Department of Materials and Science Engineering, Kroto Research Institute, University of Sheffield, Sheffield, UK.
authors.forename: Anthony
authors.initials: A
authors.lastname: Bullock
authors.affiliation: Department of Materials and Science Engineering, Kroto Research Institute, University of Sheffield, Sheffield, UK.
authors.forename: Sheila
authors.initials: S
authors.lastname: Macneil
mesh_terms: D048091:Guided Tissue Regeneration / Q000379:methods*; D006801:Humans; D056887:Pelvic Organ Prolapse / Q000628:therapy*; D033581:Stem Cell Transplantation / Q000379:methods*; D023822:Tissue Engineering / Q000379:methods*; D054457:Tissue Scaffolds; D014550:Urinary Incontinence, Stress / Q000628:therapy*
keywords: pelvic organ prolapse; stress urinary incontinensce; tissue engineering