Deterioration in biomechanical properties of the vagina following implantation of a high-stiffness prolapse mesh.
Deterioration in biomechanical properties of the vagina following implantation of a high-stiffness prolapse mesh.
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DOI：
10.1111/1471-0528.12077
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发表时间：
2013-01
期刊：
影响因子：
--
通讯作者：
Moalli P
中科院分区：
文献类型：
--
作者：
Feola A;Abramowitch S;Jallah Z;Stein S;Barone W;Palcsey S;Moalli P
通过比较原型Gynemesh PS （Ethicon, Somerville， NJ）和两种新一代低刚度网格SmartMesh （Coloplast, Minneapolis， MN）和UltraPro (Ethicon)，定义脱垂网格对阴道生物力学性能的影响。采用非人类灵长类动物模型匹兹堡大学45只分娩恒河猴子宫切除术后经骶骨固定术植入网片，并与Sham进行比较。由于其刚度具有很强的方向性，因此植入的方向分为两个方向：UltraPro垂直（较不僵硬）和UltraPro平行（较僵硬），以蓝色方向线表示。网状阴道复合体（MVC）在3个月后全部切除。主动力学性能被量化为在120 mM氯化钾存在下产生的收缩力。被动机械性能（组织抵抗施加力的能力）采用多轴协议进行测量。阴道收缩力在Gynemesh PS植入后下降80% (p=0.001)，在SmartMesh植入后下降48% (p=0.001)，在UltraPro平行植入后下降68% (p=0.001)，在UltraPro垂直植入后变化很大（p= 0.16）。Gynemesh PS对MVC被动力学行为的组织贡献显著降低（p=0.003），而SmartMesh （p=0.9）或UltraPro与植入方向无关（p=0.68和p=0.66）。使用最硬的Gynemesh PS网片植入阴道后，阴道力学性能的恶化程度最高。植入硬度增加的装置后，阴道力学性能的下降与其他使用假体作为支撑的系统的研究结果一致。
Define the impact of prolapse mesh on the biomechanical properties of the vagina by comparing the prototype Gynemesh PS (Ethicon, Somerville, NJ) to 2 new generation lower stiffness meshes, SmartMesh (Coloplast, Minneapolis, MN) and UltraPro (Ethicon). A study employing a non-human primate model University of Pittsburgh 45 parous rhesus macaques Meshes were implanted via sacrocolpexy after hysterectomy and compared to Sham. Because its stiffness is highly directional UltraPro was implanted in two directions: UltraPro Perpendicular (less stiff) and UltraPro Parallel (more stiff), with the indicated direction referring to the blue orientation lines. The mesh-vaginal complex (MVC) was excised en toto after 3 months. Active mechanical properties were quantified as contractile force generated in the presence of 120 mM KCl. Passive mechanical properties (a tissues ability to resist an applied force) were measured using a multi-axial protocol. Vaginal contractility decreased 80% following implantation with the Gynemesh PS (p=0.001), 48% after SmartMesh (p=0.001), 68% after UltraPro parallel (p=0.001) and was highly variable after UltraPro perpendicular (p =0.16). The tissue contribution to the passive mechanical behavior of the MVC was drastically reduced for Gynemesh PS (p=0.003) but not SmartMesh (p=0.9) or UltraPro independent of the direction of implantation (p=0.68 and p=0.66, respectively). Deterioration of the mechanical properties of the vagina was highest following implantation with the stiffest mesh, Gynemesh PS. Such a decrease associated with implantation of a device of increased stiffness is consistent with findings from other systems employing prostheses for support.
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影响因子：
9.8
作者：
Boreham, MK;Wai, CY;Word, RA
通讯作者：
Word, RA
影响因子：
1.8
作者：
Pulliam, Samantha J.;Ferzandi, Tanaz R.;Rosenblatt, Peter L.
通讯作者：
Rosenblatt, Peter L.
DOI：
10.2106/00004623-198769080-00014
发表时间：
1987-10-01
影响因子：
5.3
作者：
WOO, SLY;GOMEZ, MA;AKESON, WH
通讯作者：
AKESON, WH
DOI：
10.1002/jbm.10119
发表时间：
2002-04-01
期刊：
JOURNAL OF BIOMEDICAL MATERIALS RESEARCH
影响因子：
--
作者：
Klinge, U;Junge, K;Klosterhalfen, B
通讯作者：
Klosterhalfen, B
影响因子：
6.6
作者：
Rubod, Chrystele;Boukerrou, Malik;Cosson, Michel
通讯作者：
Cosson, Michel