title: In vivo response to polypropylene following implantation in animal models: a review of biocompatibility.
abstract: OBJECTIVE
  Polypropylene is a material that is commonly used to treat pelvic floor conditions such as pelvic organ prolapse (POP) and stress urinary incontinence (SUI). Owing to the nature of complications experienced by some patients implanted with either incontinence or prolapse meshes, the biocompatibility of polypropylene has recently been questioned. This literature review considers the in vivo response to polypropylene following implantation in animal models. The specific areas explored in this review are material selection, impact of anatomical location, and the structure, weight and size of polypropylene mesh types.
  
  
  METHODS
  All relevant abstracts from original articles investigating the host response of mesh in vivo were reviewed. Papers were obtained and categorised into various mesh material types: polypropylene, polypropylene composites, and other synthetic and biologically derived mesh.
  
  
  RESULTS
  Polypropylene mesh fared well in comparison with other material types in terms of host response. It was found that a lightweight, large-pore mesh is the most appropriate structure.
  
  
  CONCLUSIONS
  The evidence reviewed shows that polypropylene evokes a less inflammatory or similar host response when compared with other materials used in mesh devices.
authors.affiliation: Devices Division, The Medicines and Healthcare products Regulatory Agency (MHRA), 151 Buckingham Palace Road, London, SW1W 9SZ, UK.
authors.forename: Michelle
authors.initials: M
authors.lastname: Kelly
authors.affiliation: Devices Division, The Medicines and Healthcare products Regulatory Agency (MHRA), 151 Buckingham Palace Road, London, SW1W 9SZ, UK.
authors.forename: Katherine
authors.initials: K
authors.lastname: Macdougall
authors.affiliation: Devices Division, The Medicines and Healthcare products Regulatory Agency (MHRA), 151 Buckingham Palace Road, London, SW1W 9SZ, UK. DSS-TM@mhra.gsi.gov.uk.
authors.forename: Oluwafisayo
authors.initials: O
authors.lastname: Olabisi
authors.affiliation: Devices Division, The Medicines and Healthcare products Regulatory Agency (MHRA), 151 Buckingham Palace Road, London, SW1W 9SZ, UK.
authors.forename: Neil
authors.initials: N
authors.lastname: McGuire
mesh_terms: D000818:Animals; D001672:Biocompatible Materials / Q000009:adverse effects*; D004195:Disease Models, Animal; D005260:Female; D005549:Foreign-Body Reaction; D006801:Humans; D008422:Materials Testing / Q000379:methods*; D023421:Models, Animal; D056887:Pelvic Organ Prolapse / Q000601:surgery; D011126:Polypropylenes / Q000009:adverse effects*; D013526:Surgical Mesh / Q000009:adverse effects*; D014550:Urinary Incontinence, Stress / Q000601:surgery
chemical_list: D001672:Biocompatible Materials; D011126:Polypropylenes
keywords: Biocompatibility; Host response; Mesh; Pelvic organ prolapse; Polypropylene; Stress urinary incontinence