Polypropylene as a reinforcement in pelvic surgery is not inert: comparative analysis of 100 explants.

Abstract

INTRODUCTION AND HYPOTHESIS:

Currently, most implants used for reinforcement in surgical treatment of pelvic floor disorders are knitted monofilament polypropylene (PP). While previously recognized as inert, PP is associated with high complication rates. Some recent literature suggests polyester prosthetics based on poly(ethylene terephthalate) (PET), which may be more inert in vivo.

METHODS:

A sample of 100 implants explanted from patients due to complications was examined to evaluate the relative degradation characteristics of PP and PET prosthetics. Histological, microscopic (scanning electron microscopy, SEM) and chemical analysis (Fourier transform infrared (FTIR) spectroscopy and differential scanning calorimetry (DSC)) were conducted on these explants.

RESULTS:

Poly(ethylene terephtahlate) explants appeared to sustain less degradation in vivo than the PP explants observed in this cohort.

CONCLUSIONS:

This is the first study to evaluate synthetic implants used in a vaginal approach for pelvic floor reinforcement. The study provides evidence contrary to published literature characterizing PP as inert in such applications. Additionally, the study suggests the need for clinical trials comparatively investigating the performance of new types of monofilament prosthetics, such as those comprising PET.

• Authors: Arnaud Clavé, Hannah Yahi, Jean-Claude Hammou, Suzelei Montanari, Pierre Gounon, Henri Clavé
• Journal: International urogynecology journal (Int Urogynecol J) Vol. 21 Issue 3 Pg. 261-70 (Mar 2010) ISSN: 1433-3023 [Electronic] England
• PMID: 20052576 (Publication Type: Comparative Study, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)

Chemical References

• Polypropylenes

Topics

• Device Removal
• Female
• Foreign-Body Reaction (etiology)
• Humans
• Microscopy, Electron, Scanning
• Pelvic Organ Prolapse (surgery)
• Polypropylenes (adverse effects)
• Postoperative Complications (etiology)
• Prospective Studies
• Spectroscopy, Fourier Transform Infrared
• Surgical Mesh (adverse effects)
• Urinary Incontinence, Stress (surgery)