title: Association of urodynamics and lower urogenital tract nerve growth factor after synthetic vaginal mesh implantation on a rat model.
abstract: OBJECTIVE
  By investigating the association of urodynamics and urogenital nerve growth factor (NGF) levels in vaginal mesh surgery, we may be able to associate the likelihood of postoperative lower urinary tract symptoms developing as a result of synthetic mesh implanted for pelvic floor reconstructive surgery.
  
  
  METHODS
  Thirty-eight female Sprague-Dawley rats were divided into three groups: mesh, sham (no mesh), and control. Urodynamic study and NGF analysis of the urogenital tissues were done and results were compared among all groups. The urodynamic studies of the mesh and sham groups were further divided into the 4th and 10th days. A P-value < 0.05 was considered statistically significant.
  
  
  RESULTS
  All rats survived and no complications were observed during the post-implantation period. Histological evaluation showed intense acute inflammatory reaction on days 4 and 7 in the mesh and sham groups when compared to the control. The mesh group showed a larger area of inflammation as compared to the sham. The NGF levels increased significantly in the mesh and sham groups on the 4th and 10th days when compared to the control (P < 0.001, P < 0.001, respectively). Both the mesh and sham groups had shorter voiding interval and lower voiding volume on days 4 and 10 when compared to the control group (P < 0.001, P < 0.001, respectively). The magnitude on increasing NGF level and decreasing voiding interval and voiding volume was significantly more on the mesh group than the sham group.
  
  
  CONCLUSIONS
  A higher level of NGF in the early days post-transvaginal mesh implantation is associated with a shorter voiding interval and a smaller bladder capacity, which represents abnormal lower urinary tract symptoms following transvaginal mesh implantation.
authors.affiliation: Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Keelung Medical Center, Keelung, Taiwan, Republic of China.|Division of Urogynecology, Department of Obstetrics and Gynecology, Linkou, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan, Republic of China.|School of Medicine, Obstetrics and Gynecology, Chang Gung University, Taoyuan, Taiwan, Republic of China.
authors.forename: Tsia-Shu
authors.initials: TS
authors.lastname: Lo
authors.affiliation: Division of Urogynecology, Department of Obstetrics and Gynecology, Linkou, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan, Republic of China.|School of Medicine, Obstetrics and Gynecology, Chang Gung University, Taoyuan, Taiwan, Republic of China.
authors.forename: Yi-Hao
authors.initials: YH
authors.lastname: Lin
authors.affiliation: Division of Urogynecology, Department of Obstetrics and Gynecology, Linkou, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan, Republic of China.
authors.forename: Hsiao-Chien
authors.initials: HC
authors.lastname: Chu
authors.affiliation: Division of Urogynecology, Department of Obstetrics and Gynecology, Linkou, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan, Republic of China.|Department of Obstetrics and Gynecology, De La Salle University Medical Center, Dasmariñas, Cavite, Philippines.
authors.forename: Eileen Feliz M
authors.initials: EF
authors.lastname: Cortes
authors.affiliation: Department of Obstetrics and Gynecology, Kuala Lumpur Hospital, Kuala Lumpur, Malaysia.
authors.forename: Leng Boi
authors.initials: LB
authors.lastname: Pue
authors.affiliation: Department of Obstetrics and Gynecology, Kuching Specialist Hospital, Sarawak, Malaysia.
authors.forename: Yiap Loong
authors.initials: YL
authors.lastname: Tan
authors.affiliation: Department of Obstetrics and Gynecology, Dr. Pablo O. Torre Memorial Hospital, Bacolod City, Philippines.
authors.forename: Ma Clarissa
authors.initials: MC
authors.lastname: Uy-Patrimonio
mesh_terms: D000818:Animals; D004195:Disease Models, Animal; D005260:Female; D006801:Humans; D007249:Inflammation / Q000150:complications / Q000378:metabolism; D059411:Lower Urinary Tract Symptoms / Q000601:surgery*; D020932:Nerve Growth Factor / Q000378:metabolism*; D017773:Pelvic Floor / Q000601:surgery; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D011183:Postoperative Complications; D051381:Rats; D017207:Rats, Sprague-Dawley; D019651:Plastic Surgery Procedures; D013526:Surgical Mesh; D001743:Urinary Bladder / Q000601:surgery; D014563:Urodynamics; D013519:Urogenital Surgical Procedures / Q000379:methods*; D014621:Vagina / Q000601:surgery
chemical_list: D020932:Nerve Growth Factor
keywords: lower urinary tract symptoms; nerve growth factor; urodynamics; urogenital tissue; vaginal mesh