Cog Threads for Transvaginal Prolapse Repair: Ex-Vivo Studies of a Novel Concept
The diagnosis and treatment of pelvic organ prolapse (POP) remain a relevant and scientifically challenging topic. The number of cases of genital prolapse increases each year, one in ten women need at least one surgical procedure and one in four women in midlife have asymptomatic prolapse. Using mes...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-05-01
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| Series: | Surgeries |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2673-4095/3/2/12 |
| _version_ | 1797482189089144832 |
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| author | Catarina Soares Pedro Martins Elisabete Silva Lucie Hympanova Rita Rynkevic |
| author_facet | Catarina Soares Pedro Martins Elisabete Silva Lucie Hympanova Rita Rynkevic |
| author_sort | Catarina Soares |
| collection | DOAJ |
| description | The diagnosis and treatment of pelvic organ prolapse (POP) remain a relevant and scientifically challenging topic. The number of cases of genital prolapse increases each year, one in ten women need at least one surgical procedure and one in four women in midlife have asymptomatic prolapse. Using mesh implants to correct POP presents unsatisfactory clinical outcomes, requiring hospital readmission and further surgery. We hypothesize using an alternative surgical intervention technique, applying injectable biodegradable cog threads, currently used for face lifting procedures, to reinforce and correct vaginal wall defects. The threads used in this investigation are commercially available 360° 4D barb threads (PCL-19G-100), made of polycaprolactone (PCL), supplied in sterile packs (Yastrid, Shanghai, China). Eleven sows’ vaginal walls were used to analyze the immediate reinforcement effect of the threads. Uniaxial tensile testing and scanning electron microscopy (SEM) was performed for the initial characterization of the threads. Threads were inserted into the vaginal wall (control <i>n</i> = 5, cog <i>n</i> = 5) and were characterized by ball burst testing; a pull-out test was performed (<i>n</i> = 6). With SEM images, dimensions, such as thread diameter (≈630 µm), cut angle (≈135°), cut depth (≈200 µm) and cog distance (≈1600 µm) were measured. The mechanical behavior during uniaxial tensile testing was nonlinear. Threads could sustain 17–18 N at 18–22% of deformation. During the ball burst test, vaginal tissue reinforced with threads could support 68 N more load than normal tissue (<i>p</i> < 0.05), indicating its strengthening effect. Comfort and stress zones were significantly stiffer in the tissues reinforced with threads (<i>p</i> < 0.05; <i>p</i> < 0.05). Both groups showed identical deformation (elongation); no significant differences in the comfort zone length were observed, showing that threads do not affect tissue compliance. The pull-out test showed that the threads could sustain 3.827 ± 0.1891 N force when the first cog slip occurs, at 11.93 ± 0.8291 mm. This preliminary research on using PCL cog threads for POP treatment showed promising results in increased vaginal wall resistance to pressure load and, at the same time, not affecting its compliance. Nevertheless, to obtain long term host response in vivo, further investigation will be carried out. |
| first_indexed | 2024-03-09T22:28:42Z |
| format | Article |
| id | doaj.art-29217b1765994b5082438fc0764d4061 |
| institution | Directory Open Access Journal |
| issn | 2673-4095 |
| language | English |
| last_indexed | 2024-03-09T22:28:42Z |
| publishDate | 2022-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Surgeries |
| spelling | doaj.art-29217b1765994b5082438fc0764d40612023-11-23T19:00:41ZengMDPI AGSurgeries2673-40952022-05-013210111010.3390/surgeries3020012Cog Threads for Transvaginal Prolapse Repair: Ex-Vivo Studies of a Novel ConceptCatarina Soares0Pedro Martins1Elisabete Silva2Lucie Hympanova3Rita Rynkevic4Faculty of Engineering, University of Porto, 4200-465 Porto, PortugalAragonese Foundation for Research and Development (ARAID), Aragón Institute of Engineering Research(i3A), University of Zaragoza, 50015 Zaragoza, SpainAssociated Laboratory of Energy, Transports and Aeronautics (LAETA), Institute of Science and Innovation in Mechanical and Industrial Engineering (INEGI), Faculty of Engineering, University of Porto, 4200-465 Porto, PortugalInstitute for the Care of Mother and Child, Third Faculty of Medicine, Charles University, 100 00 Prague, Czech RepublicAssociated Laboratory of Energy, Transports and Aeronautics (LAETA), Institute of Science and Innovation in Mechanical and Industrial Engineering (INEGI), Faculty of Engineering, University of Porto, 4200-465 Porto, PortugalThe diagnosis and treatment of pelvic organ prolapse (POP) remain a relevant and scientifically challenging topic. The number of cases of genital prolapse increases each year, one in ten women need at least one surgical procedure and one in four women in midlife have asymptomatic prolapse. Using mesh implants to correct POP presents unsatisfactory clinical outcomes, requiring hospital readmission and further surgery. We hypothesize using an alternative surgical intervention technique, applying injectable biodegradable cog threads, currently used for face lifting procedures, to reinforce and correct vaginal wall defects. The threads used in this investigation are commercially available 360° 4D barb threads (PCL-19G-100), made of polycaprolactone (PCL), supplied in sterile packs (Yastrid, Shanghai, China). Eleven sows’ vaginal walls were used to analyze the immediate reinforcement effect of the threads. Uniaxial tensile testing and scanning electron microscopy (SEM) was performed for the initial characterization of the threads. Threads were inserted into the vaginal wall (control <i>n</i> = 5, cog <i>n</i> = 5) and were characterized by ball burst testing; a pull-out test was performed (<i>n</i> = 6). With SEM images, dimensions, such as thread diameter (≈630 µm), cut angle (≈135°), cut depth (≈200 µm) and cog distance (≈1600 µm) were measured. The mechanical behavior during uniaxial tensile testing was nonlinear. Threads could sustain 17–18 N at 18–22% of deformation. During the ball burst test, vaginal tissue reinforced with threads could support 68 N more load than normal tissue (<i>p</i> < 0.05), indicating its strengthening effect. Comfort and stress zones were significantly stiffer in the tissues reinforced with threads (<i>p</i> < 0.05; <i>p</i> < 0.05). Both groups showed identical deformation (elongation); no significant differences in the comfort zone length were observed, showing that threads do not affect tissue compliance. The pull-out test showed that the threads could sustain 3.827 ± 0.1891 N force when the first cog slip occurs, at 11.93 ± 0.8291 mm. This preliminary research on using PCL cog threads for POP treatment showed promising results in increased vaginal wall resistance to pressure load and, at the same time, not affecting its compliance. Nevertheless, to obtain long term host response in vivo, further investigation will be carried out.https://www.mdpi.com/2673-4095/3/2/12vaginal wallpelvic organ prolapsereinforcement techniquebiodegradable materialtissue compliance |
| spellingShingle | Catarina Soares Pedro Martins Elisabete Silva Lucie Hympanova Rita Rynkevic Cog Threads for Transvaginal Prolapse Repair: Ex-Vivo Studies of a Novel Concept Surgeries vaginal wall pelvic organ prolapse reinforcement technique biodegradable material tissue compliance |
| title | Cog Threads for Transvaginal Prolapse Repair: Ex-Vivo Studies of a Novel Concept |
| title_full | Cog Threads for Transvaginal Prolapse Repair: Ex-Vivo Studies of a Novel Concept |
| title_fullStr | Cog Threads for Transvaginal Prolapse Repair: Ex-Vivo Studies of a Novel Concept |
| title_full_unstemmed | Cog Threads for Transvaginal Prolapse Repair: Ex-Vivo Studies of a Novel Concept |
| title_short | Cog Threads for Transvaginal Prolapse Repair: Ex-Vivo Studies of a Novel Concept |
| title_sort | cog threads for transvaginal prolapse repair ex vivo studies of a novel concept |
| topic | vaginal wall pelvic organ prolapse reinforcement technique biodegradable material tissue compliance |
| url | https://www.mdpi.com/2673-4095/3/2/12 |
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