Polypropylene Pelvic Mesh: What Went Wrong and What Will Be of the Future?
Background: Polypropylene (PP) pelvic mesh is a synthetic mesh made of PP polymer used to treat pelvic organ prolapse (POP). Its use has become highly controversial due to reports of serious complications. This research critically reviews the current management options for POP and PP mesh as a viabl...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-03-01
|
| Series: | Biomedicines |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2227-9059/11/3/741 |
| _version_ | 1797613356401557504 |
|---|---|
| author | Amelia Seifalian Zeinab Basma Alex Digesu Vikram Khullar |
| author_facet | Amelia Seifalian Zeinab Basma Alex Digesu Vikram Khullar |
| author_sort | Amelia Seifalian |
| collection | DOAJ |
| description | Background: Polypropylene (PP) pelvic mesh is a synthetic mesh made of PP polymer used to treat pelvic organ prolapse (POP). Its use has become highly controversial due to reports of serious complications. This research critically reviews the current management options for POP and PP mesh as a viable clinical application for the treatment of POP. The safety and suitability of PP material were rigorously studied and critically evaluated, with consideration to the mechanical and chemical properties of PP. We proposed the ideal properties of the ‘perfect’ synthetic pelvic mesh with emerging advanced materials. Methods: We performed a literature review using PubMed/Medline, Embase, Cochrane Library (Wiley) databases, and ClinicalTrials.gov databases, including the relevant keywords: pelvic organ prolapse (POP), polypropylene mesh, synthetic mesh, and mesh complications. Results: The results of this review found that although PP is nontoxic, its physical properties demonstrate a significant mismatch between its viscoelastic properties compared to the surrounding tissue, which is a likely cause of complications. In addition, a lack of integration of PP mesh into surrounding tissue over longer periods of follow up is another risk factor for irreversible complications. Conclusions: PP mesh has caused a rise in reports of complications involving chronic pain and mesh exposure. This is due to the mechanical and physicochemical properties of PP mesh. As a result, PP mesh for the treatment of POP has been banned in multiple countries, currently with no alternative available. We propose the development of a pelvic mesh using advanced materials including emerging graphene-based nanocomposite materials. |
| first_indexed | 2024-03-11T06:54:40Z |
| format | Article |
| id | doaj.art-8e429c88c494413aa25356aac1fddc88 |
| institution | Directory Open Access Journal |
| issn | 2227-9059 |
| language | English |
| last_indexed | 2024-03-11T06:54:40Z |
| publishDate | 2023-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Biomedicines |
| spelling | doaj.art-8e429c88c494413aa25356aac1fddc882023-11-17T09:44:58ZengMDPI AGBiomedicines2227-90592023-03-0111374110.3390/biomedicines11030741Polypropylene Pelvic Mesh: What Went Wrong and What Will Be of the Future?Amelia Seifalian0Zeinab Basma1Alex Digesu2Vikram Khullar3Department of Urogynaecology, Imperial College, London W2 1NY, UKUniversity College London (UCL) Medical School, London WC1E 6DE, UKDepartment of Urogynaecology, Imperial College, London W2 1NY, UKDepartment of Urogynaecology, Imperial College, London W2 1NY, UKBackground: Polypropylene (PP) pelvic mesh is a synthetic mesh made of PP polymer used to treat pelvic organ prolapse (POP). Its use has become highly controversial due to reports of serious complications. This research critically reviews the current management options for POP and PP mesh as a viable clinical application for the treatment of POP. The safety and suitability of PP material were rigorously studied and critically evaluated, with consideration to the mechanical and chemical properties of PP. We proposed the ideal properties of the ‘perfect’ synthetic pelvic mesh with emerging advanced materials. Methods: We performed a literature review using PubMed/Medline, Embase, Cochrane Library (Wiley) databases, and ClinicalTrials.gov databases, including the relevant keywords: pelvic organ prolapse (POP), polypropylene mesh, synthetic mesh, and mesh complications. Results: The results of this review found that although PP is nontoxic, its physical properties demonstrate a significant mismatch between its viscoelastic properties compared to the surrounding tissue, which is a likely cause of complications. In addition, a lack of integration of PP mesh into surrounding tissue over longer periods of follow up is another risk factor for irreversible complications. Conclusions: PP mesh has caused a rise in reports of complications involving chronic pain and mesh exposure. This is due to the mechanical and physicochemical properties of PP mesh. As a result, PP mesh for the treatment of POP has been banned in multiple countries, currently with no alternative available. We propose the development of a pelvic mesh using advanced materials including emerging graphene-based nanocomposite materials.https://www.mdpi.com/2227-9059/11/3/741pelvic meshpolypropylenepelvic organ prolapsematerialurogynaecologygraphene |
| spellingShingle | Amelia Seifalian Zeinab Basma Alex Digesu Vikram Khullar Polypropylene Pelvic Mesh: What Went Wrong and What Will Be of the Future? Biomedicines pelvic mesh polypropylene pelvic organ prolapse material urogynaecology graphene |
| title | Polypropylene Pelvic Mesh: What Went Wrong and What Will Be of the Future? |
| title_full | Polypropylene Pelvic Mesh: What Went Wrong and What Will Be of the Future? |
| title_fullStr | Polypropylene Pelvic Mesh: What Went Wrong and What Will Be of the Future? |
| title_full_unstemmed | Polypropylene Pelvic Mesh: What Went Wrong and What Will Be of the Future? |
| title_short | Polypropylene Pelvic Mesh: What Went Wrong and What Will Be of the Future? |
| title_sort | polypropylene pelvic mesh what went wrong and what will be of the future |
| topic | pelvic mesh polypropylene pelvic organ prolapse material urogynaecology graphene |
| url | https://www.mdpi.com/2227-9059/11/3/741 |
| work_keys_str_mv | AT ameliaseifalian polypropylenepelvicmeshwhatwentwrongandwhatwillbeofthefuture AT zeinabbasma polypropylenepelvicmeshwhatwentwrongandwhatwillbeofthefuture AT alexdigesu polypropylenepelvicmeshwhatwentwrongandwhatwillbeofthefuture AT vikramkhullar polypropylenepelvicmeshwhatwentwrongandwhatwillbeofthefuture |